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目的探讨系统性红斑狼疮(SLE)患者血象下降的发生机制。方法用甲基纤维素集落培养方法观察有全血细胞减少的SLE患者的血清、去除IgG后的血清对正常骨髓造血干(祖)细胞粒细胞-巨噬细胞集落(CFU-GM)、红系祖细胞集落(CFU-E)的影响及SLE患者造血干(祖)细胞的增殖能力。结果①加入SLE患者的血清可见66.7%的正常骨髓CFU-GM、70%的CFU-E集落形成减少,与对照组比较差异均有显著性(P<0.001)。②去除IgG后的血清组CFU-GM、CFU-E的产率高于未去除IgG血清组(P<0.001)。③SLE患者骨髓CFU-GM、CFU-E集落数均明显低于正常对照组(P<0.01)。结论SLE患者的全血细胞减少与其血清自身抗体抑制造血干(祖)细胞有关,也与其本身干(祖)细胞的增殖分化能力下降有关。
Objective To investigate the mechanism of blood loss in patients with systemic lupus erythematosus (SLE). Methods The serum of SLE patients with pancytopenia was observed by methylcellulose colony culture. Serum samples from normal SLE patients with normal serum were used to detect the effect of CFU-GM, Cell colonies (CFU-E) and SLE patients with hematopoietic stem (progenitor) cells proliferation. Results ① The percentage of CFU-GM in normal bone marrow and the percentage of CFU-E in 70% decreased in 66.7% of the patients with SLE. The difference was significant compared with the control group (P <0.001). (2) The yield of CFU-GM and CFU-E in the serum group after IgG removal was higher than that of the IgG group without serum IgG removal (P <0.001). ③SLE patients with bone marrow CFU-GM, CFU-E colonies were significantly lower than the normal control group (P <0.01). Conclusion The decrease of pancytopenia in patients with SLE is related to the inhibition of hematopoietic stem (progenitor) cells by serum autoantibodies and the decrease of proliferation and differentiation of stem cells in SLE patients.