白血病患儿外周血T细胞亚群检测的临床意义

Clinical Significance of Detecting Peripheral T Cell Subsets in Children with Leukemia

本研究观察急性白血病患儿外周血T细胞在不同病程阶段的变化,了解白血病患儿的免疫状况。应用流式细胞术检测42例急性白血病患儿,另选取50例正常儿童(对照组)外周血CD4+、CD8+、CD4+/CD8+比值、CD3+以及NK细胞在不同病程阶段的动态变化。结果表明:急性淋巴细胞白血病(ALL)与急性髓系白血病(AML)初诊患儿的CD3+,CD4+、CD8+细胞比例和CD4+/CD8+比值均值显著低于对照组(P<0.05),初诊时急性白血病患儿的NK细胞值显著低于对照组(P<0.05);ALL与AML患儿完全缓解期(CR)3、6和12个月时的NK细胞水平虽然缓慢上升,但与对照组比较仍具有统计学差异(P<0.05)。结论:急性白血病患儿在病情发生以及治疗过程中细胞免疫功能存在紊乱,经治疗获CR后患儿病情好转,细胞免疫渐渐恢复,但恢复速率慢,该结果为患儿后续使用免疫调节剂治疗提供依据。

This study was purposed to investigate the changes of peripheral blood T cells in children with acute leukemia at different stages and understand the immune status of children with leukemia.The CD4^＋,CD8^＋,CD4^＋ /CD8^＋ ratioCD3^＋ and NK cells in 42 children with acute leukemia and 50 cases of normal children（ as control group）were determined by flow cytometry at different periods after complete remission.The results showed that the CD3^＋CD4^＋,CD8^＋ rate and CD4^＋ /CD8^＋ ratio in newly diagnosed ALL and AML children were significantly lower than those in control group（ P〈0.05）.The NK cell count in newly diagnosed children with acute leukemia was significantly lower than that in control group（ P〈0.05）.Although the NK cell count in ALL and AML children gradually rose at 36 months after complete remissionbut it still was statistieally different from normal control group（ P〈0.05）.It is concluded that children with acute leukmia have cellular immune disfunction at onset and during tretmentbut the cell immune function gradually recovered after complete remission achieved.Howeverits recovery rate is slow.The results of this study can providea a basis for subsequently use of immunomodulations in leukemia children.