Treg细胞、NK细胞及T淋巴细胞亚群的水平变化对急性白血病的临床诊治意义评价

Clinical significance of diagnosis and treatment of Treg cells,NK cells and T lymphocyte subsets in patients with acute leukemia

目的:分析急性白血病(AL)外周血内免疫细胞水平变化的临床价值。方法:选取120例AL患者和50例健康体检者作为研究对象,分别纳入初诊组(107例)、移植组(13例)、对照组(50例),比较各组外周血内免疫细胞水平的差异。结果:初诊组107例患者中,完全缓解(CR)63例(58.88%),部分缓解10例(9.35%),未缓解22例(20.56%),其余12例(11.21%)死亡或放弃治疗。初诊组患者入组时、CR患者治疗后1个月、未缓解者治疗后Treg细胞显著高于对照组,NK细胞显著低于对照组(P<0.05);CR患者治疗后3个月、移植组患者移植成功后Treg细胞、NK细胞与对照组比较,差异无统计学意义(P>0.05)。初诊组患者入组时、未缓解者治疗后、移植组患者移植成功后CD4^+、CD4^+/CD8^+水平显著低于对照组(P<0.05);CR患者治疗后1个月及治疗后3个月T淋巴细胞亚群与对照组比较,差异无统计学意义(P>0.05)。结论:长期监测AL患者外周血Treg细胞、NK细胞及T淋巴细胞亚群水平有助于明确治疗效果、预测预后质量。

Objective：To analyze the clinical value of changes of peripheral blood immune cells in patients with acute leukemia（AL）.Method：A total of 120 AL patients and 50 normal subjects were enrolled,and were divided into initial diagnosis group（n=107）,allo-HSCT group（n=13）,and control group（n=50）.We compared the differences of immune cell level in peripheral blood of patients in different groups.Result：Among 107 cases in the initial diagnosis group,63 cases（58.88%）achieved complete remission（CR）,10 cases（9.35%）achieved partial remission,22 cases（20.56%）had no remission,and the other 12 cases（11.21%）were dead or give up the treatment.In the initial diagnosis group,the level of Treg cells of CR patients treated 1 month and of the patients with no remission were significantly higher than that in control group,NK cells were lower than that in control group（P〈0.05）.There was no significant difference in the levels of Treg cells,NK cells among CR patients after treatment for 3 months and patients in allo-HSCT group after transplantation and the control group（P〈0.05）.The levels of CD4＋,CD4＋/CD8＋ of the no remission and initial diagnosis group in the period of start study and the allo-HSCT group after successful transplantation,were lower than those in control group（P〈0.05）.In the CR patients,after treatment for 1 month and 3 months,the level of T lymphocyte subsets had no statistical significant（P〈0.05）.Conclusion：Long term monitoring of Treg cells,NK cells and T lymphocyte subsets level of peripheral blood in AL patients could be help to clarify its therapeutic effect and predict the prognosis of quality.