慢性淋巴细胞白血病外周血T细胞亚群及免疫球蛋白研究

T lymphocyte subsets and immunoglobulin state in peripheral blood of patients with chronic lymphocytic leukemia

目的分析慢性淋巴细胞白血病(CLL)患者的免疫状态及其与疾病分期的关系。方法应用流式细胞术(FCM)分析60例 B-CLL 患者外周血 T 淋巴细胞亚群的变化,用免疫速率比浊法分析其中37例患者血清中 IgG、IgA 和 IgM 的变化,比较各 Binet 分期患者免疫功能的变化。结果与正常对照组相比,60例 B-CLL 患者外周血中 CD_3^+、CD_4^+和 CD_8~4细胞比率均明显降低(P<0.01),Binet B、C 期组患者CD_4^+/CD_8^+比值也明显低于 Binet A 和正常对照组(P<0.01)。37例 B-CLL 患者中有21例患者(56.8%)出现有免疫球蛋白(Ig)减低的情况。Binet C 期组 Ig 减低发生率高于 Binet A 和 B 期(P<0.05),Binet C期组 IgG、IgA、IgM 的平均水平明显低于 Binet A 和 B 期组(P<0.05)。结论 CLL 患者存在细胞免疫和体液免疫功能的低下,与 CLL 病程密切相关。检测 CLL 患者外周血 T 细胞亚群及 Ig 水平的变化,对了解CLL 免疫功能状态,从而判断病情具有重要作用。

Objective To evaluate the immune state and its relationship with Binet stages in patients with chronic lymphocytic leukemia(CLL).Methods The peripheral blood T lymphocyte subsets were detect- ed by flow cytometry(FCM)in 60 patients with B-CLL,and immunoglobulin(Ig)was detected by immunotur- bidimetry in 37 cases.Results The levels of CD_3^+,CD_4^+,CD_8^+ were depressed more significantly in Binet A,B,C stages of CLL as compared with healthy controls(P<0.01),and CD_4^+/CD_8^+ was decreased more significantly in Binet B、C stages as compared with Binet A stage and healthy controls(P<0.01).The levels of Ig were de- pressed in 21 out of 37 patients(P<0.05),and lower significantly in Binet C stage than that in Binet A and B stages(P<0.05).Conclusion Immune functions,including the levels of CD_4^+/CD_8^+ and Ig,were depressed in CLL patients,and related to Binet stages.The analysis of lymphocyte subsets and Ig were helpful to evaluate the severity in CLL.