急性白血病患者T细胞亚群的变化及其与临床特征和预后的关系

Changes of T cell subsets in patients with acute leukemia and their relationship with clinical characteristics and prognosis

目的:探讨分析急性白血病(AL)患者T细胞亚群的变化及其与临床特征和预后的关系。方法:选取2016年6月~2018年6月在我院进行治疗的AL患者80例作为观察组,将其按核型分析和基因检测分为低、中和高危组,例数分别为24例、27例和29例;治疗后按其疗效再次分为三组,分别为完全缓解组41例,复发组17例以及未缓解组22例,并选择同期健康志愿者40例作为正常对照组。对以上各组的T细胞亚群情况进行分析。结果:初诊AL组与正常对照组相比,CD3+T、CD4+T以及CD4+T/CD8+T均显著降低,CD8+T显著升高。低、中、高危三组患者的CD3+T、CD4+T、CD8+T以及CD4+T/CD8+T比较,均无显著性差异;且两两比较,无显著性差异。治疗后,与完全缓解组相比,未缓解组的CD3+T、CD4+T以及CD4+T/CD8+T水平均降低,CD8+T水平升高;复发组的CD3+T、CD4+T水平均升高。与未缓解组相比,复发组的CD3+T、CD4+T以及CD4+T/CD8+T水平均升高。结论:通过对AL患者的T细胞亚群的变化情况进行监测,可以了解患者机体的免疫应答情况,对于临床治疗具有一定的指导意义。

Objective To investigate and analyze the changes of T cell subsets in patients with acute leukemia(AL)and their relationship with clinical characteristics and prognosis.Methods 80 patients with AL treated in our hospital from June 2016 to June 2018 were selected as the observation group,and were divided into low,medium and high risk groups according to karyotype analysis and gene detection,with 24 cases,27 cases and 29 cases respectively.After treatment,they were again divided into three groups according to their therapeutic effects,namely 41 cases in complete remission group,17 cases in relapse group and 22 cases in non-remission group,and 40 healthy volunteers in the same period were selected as normal control group.The T cell subsets of the above groups were analyzed.Results Compared with the norm AL control group,the levels of CD3+T,CD4+T and CD4+T/CD8+T in the newly diagnosed al group decreased significantly,while the level of CD8+T increased significantly.There was no significant difference in CD3+T,CD4+T,CD8+T and CD4+T/CD8+Tamong the low,medium and high risk groups of patients.There was no significant difference between the two groups.After treatment,compared with the complete remission group,the levels of CD3+T,CD4+T and CD4+T/CD8+T in non-remission group decreased and the levels of CD8+T increased.The levels of CD3+T and CD4+T in relapse group increased.Compared with non-remission group,the levels of CD3+T,CD4+T and CD4+T/CD8+T in relapse group were increased.Conclusion By monitoring the changes of T cell subsets in patients with AL,the immune response of patients can be understood,which has certain guiding significance for clinical treatment.