细胞免疫功能在急性淋巴细胞白血病患儿初诊中的临床意义研究

Clinical significance of cellular immune function in the initial diagnosis ofchildren with acute lymphoblastic leukemia

目的研究儿童急性淋巴细胞白血病(cALL)初诊时细胞免疫功能的临床意义。方法采用回顾性研究,收集82例新发cALL患者(cALL组)和28例正常体检儿童(对照组)的临床、实验室资料,比较cALL组与对照组临床指标,评估cALL组初诊指标相关性,回归评估cALL组危险度与初诊指标,分析初诊时细胞免疫功能的临床意义。结果cALL组自然杀伤细胞(NK细胞)百分比和效应T细胞(Tef细胞)百分比均显著低于对照组,调节性T细胞(Treg细胞)百分比和Treg/Tef比值高于对照组,差异均有统计学意义(P<0.05)。CD4^(+)T细胞百分比、CD8^(+)T细胞百分比及Tef细胞百分比与白细胞计数(WBC)呈负相关,CD4^(+)T细胞百分比与血红蛋白(Hb)呈负相关,B细胞百分比与血小板计数(Plt)呈负相关,Tef细胞百分比与Plt呈正相关,差异均有统计学意义(P<0.05)。初诊CD4^(+)T细胞百分比是危险度评估的影响因素(P<0.05)。结论初诊时细胞免疫功能与cALL患者的发生有关,在评估危险度方面有一定的临床意义。

Objective To study the clinical significance of cellular immune function at the initial diagnosis of childhood acute lymphoblastic leukemia(cALL).Methods A retrospective study was used.The clinical and laboratory data of 82 new-onset cALL patients(cALL group)and 28 normal physical examination children(control group)were collected.The clinical indicators of the cALL group and the control group were compared,and the correlation of the initial diagnosis indicators in the cALL group was evaluated.Regression was used to evaluate the risk and indicators of the first diagnosis in the cALL group,and the clinical significance of the cellular immune function at the first diagnosis was analyzed.Results The percentage of NK cells and the percentage of Tef cells in the cALL group were significantly lower than those of the control group,and the percentage of Treg cells and the ratio of Treg/Tef were higher than those in the control group,and the differences were statistically significant(P<0.05).CD4^(+)T cell percentage,CD8^(+)T cell percentage and Tef cell percentage are negatively correlated with white blood cell count(WBC),the percentage of CD4^(+)T cells is negatively correlated with hemoglobin(Hb),the percentage of B cells is negatively correlated with platelet count(Plt),the percentage of Tef cells was positively correlated with Plt,and the differences were statistically significant(P<0.05).The percentage of newly diagnosed CD4^(+)T cells was an influencing factor for risk assessment(P<0.05).Conclusion The cellular immune function at the first diagnosis is related to the occurrence of cALL patients,and has certain clinical significance in assessing the risk.