再生障碍性贫血患者免疫T细胞亚群表达与三氧化二砷联合环孢素治疗效果的相关性

Relationship between expression of immune T cell subsets and therapeutic effect of arsenic trioxide combined with cyclosporine in patients with aplastic anemia

目的探讨再生障碍性贫血(AA)患者免疫T细胞亚群表达与三氧化二砷联合环孢素治疗效果的相关性。方法将郑州大学第二附属医院2018年7月至2020年1月接受三氧化二砷联合环孢素治疗后有效的AA患者32例纳入有效组,将同期接受相同治疗方案无效的AA患者31例纳入无效组。所有患者入院当天均接受免疫T细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))检测。分析CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平与治疗效果的关系。结果入院时,有效组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于无效组,有效组CD8^(+)水平低于无效组,差异有统计学意义(P <0.05)。经Logistic回归分析结果显示,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平过低、CD8^(+)水平过高可能是影响治疗疗效的影响因素(OR> 1,P <0.05)。结论免疫T细胞亚群水平变化会直接影响三氧化二砷联合环孢素AA患者治疗效果,在未来可用于临床AA治疗效果评估中。

Objective To investigate the relationship between the expression of immune T cell subsets and the therapeutic effect of arsenic trioxide combined with cyclosporine in patients with aplastic anemia( AA). Methods Thirty-two aplastic anemia patients who received arsenic trioxide combined with cyclosporine in the Second Affiliated Hospital of Zhengzhou University from July 2018 to January2020 were included in the effective group,and 31 AA patients who received the same treatment plan at the same time were included in the invalid group. On the day of admission,all patients were tested for immune T cell subsets( CD3 ^(+),CD4 ^(+),CD8 ^(+),CD4 ^(+)/CD8 ^(+)). The relationship between the levels of CD3^(+),CD^(+),CD8^(+),CD4^(+)/CD8^(+)and the therapeutic effect was analyzed. Results At admission,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the effective group were higher than those in the ineffective group,and the CD8 ^(+) level in the effective group was lower than that in the ineffective group,the differences were significant( P < 0. 05). The logistic regression analysis showed that the low levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and the high level of CD8^(+)might be the influencing factors of the therapeutic effect( OR > 1,P < 0. 05). Conclusions The level of immune T cell subsets will directly affect the therapeutic effect of arsenic trioxide combined with cyclosporine AA,which can be used in the clinical evaluation of therapeutic effect of AA in the future.