重型再生障碍性贫血患者T细胞亚群的变化及临床意义

Changes and clinical significance of T-cell subsets in patients with severe aplastic anemia

目的:检测T细胞亚群在重型再生障碍性贫血(severe aplastic anemia,SAA)中的变化及预后意义。方法:选择我科SAA患者103例为SAA组,以健康成年人100例为对照组,采用流式细胞术分析初诊时外周血CD3+、CD4+、CD8+T淋巴细胞数量及CD4+/CD8+比值。SAA组按治疗方法分为免疫抑制治疗组(IST组)及IST联合脐带间充质干细胞(UCMSCs)组,观察不同治疗组间疗效及上述指标的变化。结果:与对照组相比,SAA组CD4+、CD8+T淋巴细胞数具有统计学意义(P<0.05),CD4+/CD8+比值倒置,具有显著性差异(P<0.01)。IST组治疗前后CD3+T淋巴细胞数及CD4+/CD8+比值有显著性差异(P<0.05)。IST联合UC-MSCs组治疗前后CD8+、CD4+T淋巴细胞数及CD4+/CD8+比值均有显著性差异(P<0.01)。结论:SAA患者CD4+/CD8+比值倒置,提示免疫异常与SAA的发病机制关系密切。IST联合UCMSCs治疗更有利于促进SAA患者骨髓造血能力的恢复,不良反应少。流式细胞术行T淋巴细胞检测对探讨SAA的发病机制、提高诊断及选择合理的治疗方案具有重要价值。

Objective:To investigate the changes and clinical significance of T-cell subsets in patients with severe aplastic anemia(SAA).Methods:The T-cell subtype and the ratio of CD4+/CD8+ cell in the peripheral blood mononuclear cell of 103 SAA patients diagnosed in our department were analyzed by flow cytometry.Results:CD4+ T-cell counts and CD4+/CD8+ratio were significant lower,CD8+ Tcell counts were significant higher in SAA group comparing with control group(P <0.05).Conclusion:Immunologic abnormality maybe involved in the pathogenesis of SAA.