造血干细胞移植后患者淋巴细胞免疫重建的研究

Study of lymphocyte immune reconstitution after hematopoietic stem cell transplantation

目的:探讨造血干细胞移植后患者淋巴细胞亚群变化及影响因素。方法:选择我院40例造血干细胞移植患者及20例健康供者为研究对象,取外周血,通过流式细胞仪进行淋巴细胞亚群(CD4+T细胞、CD8+T细胞、NK细胞、B细胞)检测,检测分移植后1个月、3个月、6个月和1年4个时间点。结果:移植后淋巴细胞恢复迅速;NK细胞移植后1个月已恢复至正常水平;移植后3个月时B细胞仍极少,6个月时恢复至正常水平;CD8+T细胞恢复快于CD4+T细胞;单倍体移植患者B细胞恢复慢于全相合移植患者;血清CMV阳性患者CD4+T细胞低于阴性患者;预处理应用抗胸腺球蛋白(ATG)患者初始CD4+T细胞恢复慢于未应用ATG患者。结论:移植后患者免疫系统受损,不同淋巴细胞亚群恢复过程各有其特点,多种因素影响免疫重建过程。

Objective： To investigate the changes of lymphocyte subsets and its influencing factors in patients having received hematopoietic stem cell transplantation（ HSCT）. Methods： The different level of peripheral blood CD4＋T cells,CD8＋T cells,NK cells and B cells from 40 patients having received hematopoietic cell transplantation and 20 normal people were detected by flow cytometer. We analyzed lymphocytes in 1 month,3 months,6 months and 1 year after transplantation. Results： The absolute number of lymphocytes recovered quickly after transplantation; the NK cells went back to normal in 1 month; B cells count recovered in 6months; the B cells recovery was slow in the patients who received haploidentical HCT; CD4＋T cell counts was lower in cytomegalovirus seropositive patients; naive CD4＋T cell reconstitution after ATG-conditioned HCT was slow. Conclusion： The immune system is damaged after HSCT. The recovery process of different lymphocyte subsets has its own characteristics. The immune reconstitution affected by many factors.