急性白血病患者外周血淋巴细胞亚群和调节性T细胞的检测及临床意义

Detection of lymphocyte subsets,regulatory T cells in peripheral blood of patients with acute leukemia and its clinical significance

目的:研究急性白血病患者外周血淋巴细胞亚群、调节性T细胞水平的变化及临床意义。方法:采用流式细胞仪对60例急性白血病(AL)患者[急性髓细胞性白血病(AML)30例、急性淋巴细胞性白血病(ALL)30例]及40例正常人外周血淋巴细胞亚群及调节性T细胞水平进行检测。结果:初诊AL组与正常对照组比较,CD3+T淋巴细胞百分比、CD4+T淋巴细胞百分比、CD4+/CD8+比值及CD16+/56+NK细胞百分比均明显降低(P<0.05);CD8+T淋巴细胞百分比与CD19+B淋巴细胞百分比均明显升高(P均<0.01)。ALL组CD4+T淋巴细胞百分比及CD4+/CD8+比值明显低于AML组(P<0.01)。与对照组相比较,初诊AL患者外周血CD4+CD25+T细胞和CD4+CD25highTreg细胞均明显升高(P<0.01)。结论:AL患者细胞免疫功能明显异常;与AML患者相比,ALL患者细胞免疫功能更为低下。CD4+CD25highTreg细胞增多可能是AL患者免疫功能受抑的重要原因之一。淋巴细胞亚群及调节性T细胞水平检测在评价AL疗效及判断预后方面具有一定的临床价值。

Objective：To study the changes of lymphocyte subsets,regulatory T cells in peripheral blood of patients with acute leukemia（AL） and its clinical significance.Methods： The level of peripheral blood lymphocyte subsets,regulatory T cells of 60 AL patients and 40 normal controls were detected with flow cytometry.Results： Compared with the normal controls,the percentage of CD3＋ T cell,CD4＋Tcell,CD16＋CD56＋ NK cell and the ratio of CD4＋/CD8＋ decreased obviously in newly diagnosed AL group（P0.05）,while the percentage of CD8＋ T cell and CD19＋ B cell increased significantly（P 0.01）.The percentage of CD4＋T cell and the ratio of CD4＋/CD8＋ in acute lymphoblastic leukemia（ALL） group were much lower than those in acute myelogenous leukemia（AML） group（P0.01）.Compared with that of control group,the proportion of CD4＋CD25 high Treg cells and CD4＋ CD25＋ T cells in newly diagnosed AL group were significantly increased（P0.01）.Conclusion： Cellular immune function is significantly abnormal in patients with AL.Compared with AML,patients with ALL had more poor cellular immune function.The increased number of CD4＋ CD25 high Treg cells might be one of the important reason of immunosuppression in AL.Detection of lymphocyte subsets and regulatory T cells are of clinical value on evaluation of therapeutic effect and prognosis of AL.