去白细胞输血对恶性血液病患者免疫活性细胞的影响  

Effect of allogenic blood transfusion on cellular immune function of patients with hematologic malignances

作　　者：陆紫敏[1] 纪黎明[1] 祖亚钧[1] 梁萍[1] 方琦[1] 

机构地区：[1]同济大学附属同济医院输血科,上海200065

出　　处：《临床血液学杂志（输血与检验）》2008年第2期183-185,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

摘　　要：目的:观察应用输血治疗的恶性血液病化疗患者外周血T细胞亚群及NK细胞活性,探讨去白细胞输血对恶性血液病患者免疫活性细胞的影响。方法:将120例化疗期间需要接受输血治疗的恶性血液病患者分为2组:A组59例接受去白细胞输血;B组61例接受常规输血。2组每次的输血量、输血次数及化疗方案基本相同。对2组治疗前后的T细胞及NK细胞活性进行检测,并与对照组进行比较。结果:①恶性血液病患者各项免疫活性细胞表达均低于对照组(P<0.01);②治疗前A、B2组免疫活性细胞表达差异无统计学意义,治疗后A组的NK细胞活性明显高于B组(P<0.01);A组治疗后CD3+、CD4+、CD4+/CD8+、NK细胞活性明显高于治疗前(P<0.05);③B组发生非溶血性发热反应(NHFTR)率明显高于A组(P<0.01)。结论:T细胞亚群、NK细胞活性在恶性血液病患者中受到明显抑制;与常规的输血治疗方法相比,去白细胞输血能明显改善恶性血液病患者的细胞免疫功能,尤其是对NK细胞,并能有效预防NHFTR。Objective：To test peripheral blood T cell and NK cell activity both before and after allogenic transfusion in patients with hematologic malignances and observe effects of leukocyte-reduced allogenic blood transfusion on cellular immune function . Method： 120 patients with hematologic malignances were randomly and equally divided into two groups： the group of A received leukocyte-reduced allogenic blood transfusion, the group of B allogenic blood transfusion. T cell subsets and NK cell activity were determined by monoclonal antibody and flow cytometry （FCM）analysis respectively, and the data were compared with that of the controls with benign diseases. Result：① The immune indexes of patients with advanced and recurrent hematologic malignances were lower than those of the control group（P 〈0.01）. ② After treatment, the NK cell activity of A group was significantly increased than that of B group（P〈0.01）;and the peripheral blood of T cell subsets and NK cell activities in A group were significantly increased than those before the treatment（P〈0.05）. ③The rate of Non-hemolytic febrile transfusion reaction （NHFTR） happening in B group was significantly higher than that in A group（P〈0.01）. Conclusion： The peripheral blood of T cell subsets and NK cell activities are significantly suppressed in patients with hematologic malignances. Compared with regular blood transfusion, the leukocyte-reduced allogenic blood transfusion can apparently improve the cellular immune function of patients with hematologic malignances, especially for NK cell, and it might prevent NHFTR effectively.

关 键 词：恶性血液病 免疫活性细胞 去白细胞输血 流式细胞仪 

分 类 号：R55[医药卫生—血液循环系统疾病]