Tien S L, Ong Y W, Tan P, Tan H
Haematology Department, Singapore General Hospital.
Ann Acad Med Singap. 1993 Mar;22(2):242-6.
Sixty-five patients with haemophilia A from Singapore General Hospital, treated within the last 15 years exclusively with cryoprecipitate, were studied for the effect of the total number of exposures to random blood donors on their immune system. These haemophiliacs were aged 4 to 71 years (median 24 years) and were all apparently healthy with no clinical evidence of viral infection. None of them was a homosexual or intravenous drug user. All of them tested negative for human immuno-deficiency virus antibody and hepatitis B surface antigen. Analysis of the T-lymphocyte subset population showed 20 out of 65 haemophiliacs or 30.8% had reversal of T4/T8 ratio, ie. less than 1.00. There was no significant difference in the mean age of the 20 patients with abnormal T4/T8 ratios compared with the 45 with normal T4/T8 ratios. The mean age of the former group was 23 and the latter was 25. The group with reversal of T4/T8 ratio had exposure to 827.4 +/- 137.3 (mean +/- SEM) random blood donors, which is significantly higher than 402.5 +/- 64.1 in the group with normal T4/T8 ratio (p < 0.05). The reversal of T4/T8 ratio is predominantly due to the suppression of absolute T4 cell counts, with slightly raised absolute T8 cell counts. This abnormality may be transient or permanent. Interestingly, all the six out of 65 haemophiliacs with factor VIII inhibitor did not show any reversal of T4/T8 ratio in this study.
对新加坡总医院过去15年间仅接受冷沉淀治疗的65例甲型血友病患者进行了研究，以探讨接触随机供血者的总次数对其免疫系统的影响。这些血友病患者年龄在4至71岁之间（中位数为24岁），表面上均健康，无病毒感染的临床证据。他们均非同性恋者或静脉吸毒者。所有人的人类免疫缺陷病毒抗体和乙型肝炎表面抗原检测均为阴性。对T淋巴细胞亚群的分析显示，65例血友病患者中有20例（即30.8%）T4/T8比值倒置，即小于1.00。T4/T8比值异常的20例患者的平均年龄与T4/T8比值正常的45例患者相比，无显著差异。前一组的平均年龄为23岁，后一组为25岁。T4/T8比值倒置的组接触了827.4±137.3（平均值±标准误）个随机供血者，这显著高于T4/T8比值正常组的402.5±64.1（p<0.05）。T4/T8比值倒置主要是由于绝对T4细胞计数的抑制，同时绝对T8细胞计数略有升高。这种异常可能是暂时的或永久的。有趣的是，在本研究中，65例患有因子VIII抑制剂的血友病患者中有6例均未出现T4/T8比值倒置。
