T细胞亚群对急性白血病化疗预防性抗真菌治疗价值分析

The Value of T cell subsets in the prevention and treatment of acute leukemia after chemotherapy

目的:分析急性淋巴细胞白血病化疗外周血中T细胞亚群的变化,探讨T细胞亚群变化与继发真菌感染及预防性抗真菌感染的指导价值。方法:缓解期的急性淋巴细胞白血病(ALL)27例,随机分组,2次巩固化疗前,外周血白细胞≥4.0×109/L时,用流式细胞术分别检测化疗后患者外周血中CD+3、CD+4、CD+8、CD+4/CD+8细胞的百分数,进行统计分析。结果:治疗组真菌感染率较对照组低;随着化疗次数的增加,T细胞亚群的比例明显失调,CD+4细胞百分数下降,差异有统计学意义(P<0.01),CD+8细胞百分数上升,差异有统计学意义(P<0.05),CD+4/CD+8细胞比值严重倒置,差异有统计学意义(P<0.01);T细胞亚群变化对预防性抗真菌感染有指导价值。结论:ALL患者免疫活性细胞随着化疗次数的增加受到明显影响,对T细胞亚群的比例明显失调者尽早联合预防性抗真菌治疗有效。

Objective To analyze the relationship between the acute lymphoblastic leukemia chemotherapy and the changes of T lymphocyte subsets in peripheral blood,and to explore the changes of T lymphocyte subgroups which have the guidance value to secondary fungus infection and prophylactic antifungal infection. Method 27 cases of the acute lymphoblastic leukemia（ ALL）,which number of White blood cells were greater than or equal to 4. 0 × 109/ L,and flow cytometry was used to detect the percentage of CD＋3,CD＋4,CD＋8and CD＋4/ CD＋8cells in peripheral blood of patients after chemotherapy. Results The fungi infection rate of treatment group was lower than those of control group; With the increase of frequency of chemotherapy,imbalanced percentage of T cells subgroup was obvious,the percentage of CD＋4cells was decreased（ P〈0. 01）,the percentage of CD＋8cells was increased（ P〈0. 05）,the ratio of CD＋4/ CD＋8cells was severely inverted（ P〈0. 01）; The changes of T cells subgroup to prophylactic antifungal infection have guidance value. Conclusion With the increase of frequency of chemotherapy,the immune activity cells are decreased. Patients with ALL are obviously affected by the T cells subgroups＇ disorder. It is necessary to combine effective antifungal prophylaxis as soon as possible.