32例再生障碍性贫血患儿淋巴细胞免疫分析及临床意义  

Analysis and Clinical Significance of Lymphocyte Immune in 32 Cases of Children Aplastic Anemia

作　　者：张熔[1] 李运碧[1] 李戈[1] 张辉 叶太惠 

机构地区：[1]四川省人民医院,四川成都610072 [2]四川省交通厅公路局成都医院,四川成都610041

出　　处：《现代临床医学》2009年第1期17-19,共3页Journal of Modern Clinical Medicine

摘　　要：目的:评价T细胞亚群、免疫调节T细胞(CD3+、CD4+、CD2+5)、自然杀伤细胞(CD3-、CD1+6、CD2+5)在再生障碍性贫血(AA)患儿细胞免疫功能紊乱中的作用及其与AA发病、免疫抑制治疗之间的关系。方法:临床初诊AA患儿32例,采用流式细胞术检测外周血T淋巴细胞亚群、免疫调节T细胞和自然杀伤细胞水平,并与正常儿童35例对照。病例组分为免疫正常组和免疫异常组,均接受常规和常规联合免疫抑制治疗。结果:与对照组比较,初诊再障患儿外周血CD8+、CD25+T细胞均显著增高(P<0.01),CD4+T细胞(P<0.05)、CD3-、CD1+6、CD5+6细胞(P<0.01)、CD4+/CD8+比值(P<0.05)均显著降低;淋巴细胞免疫异常型患儿的免疫治疗组有效率高于常规治疗组(P<0.05)。结论:大多数AA患儿存在CD4+/CD8+比值失调,CD2+5T细胞和自然杀伤细胞参与了发病,淋巴细胞亚群检测对临床了解发病机理、合理选择治疗方案具有重要价值。Objective： To evaluate the role of T cell subgroups, regulatory T cells （ CD3^＋ . CD4^＋, CD25^＋ ）, natural killer cells （ CD3^- ,CD16^＋ ,CD25^＋ ） in children aplastic anemia with cellular immune dysfunction and its relationship between the pathogen of AA and the immunosuppressive therapeutic effect. Methods ：The phenotypes of lymphocytes, the levels of T cell subgroups, regulatory T lymphocytes, natural killer cell in peripheral blood of IAA patients were measured at the onset of disease by flow cytometry and were compared with that in normal controls. Patients were 32 cases and 35 cases in the control. Patients were divided into the normal and abnormal immune group, and were to accept conventional therapy and conventional therapy combined with immunotherapy. Results：The levels of CD8^＋ ,CD25^＋ T cells in AA group were significantly higher than those in control（ P 〈 0. 01 ）. The levels of CD4T cells（P 〈0. 05）, CD3^- ,CD16^＋ ,CD56^＋ lymphocytes（P 〈0. 01 ） ,ratios of CD4^＋/CD8^＋ （P 〈0. 05） in AA group were lower compared with control group. Therapeutic effecacy of lymphocyte immune abnormal type in the immunotheray was significantly higher than conventional treatment group （P 〈 0. 05）. Conclusion：Significant abnormal ratios of CD4^＋/CD8^＋ exist in the majority of AA patients, abnormal CD25^＋ T cells, natural killer cells play an important role at the onset of childhood idiopathic aplastie anemia. It is important that the detection of lymphocytes in patients with aplastic anemia contributes to understand pathogen of AA and choice of rational treatment.

关 键 词：再生障碍性贫血 T细胞亚群 CD4^+ CD8^+ CD25^+ CD56^+ 

分 类 号：R725.5[医药卫生—儿科]