外周血T淋巴细胞亚群比例对免疫抑制治疗急性再生障碍性贫血患儿预后预测的意义  

Significance of Peripheral T-Lymphocyte Subset Proportions on Predicting Prognosis of Acute Aplastic Anemia Treated with Immunosuppressive Therapy in Children

作　　者：邹纬[1] 冯晓勤[1] 李春富[1] 何岳林[1] 吴学东[1] 石磊[1] 李娜[1] 

机构地区：[1]南方医科大学南方医院儿科,广州510515

出　　处：《实用儿科临床杂志》2010年第3期184-185,206,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨采用免疫抑制治疗急性再生障碍性贫血(AA)患儿的效果及与治疗前外周血T淋巴细胞亚群分类比例的关系。方法选取本科2000-2007年收治的43例接受免疫抑制治疗的急性AA患儿,依据治疗结果将患儿分为有效组和无效组。对2组患儿治疗前外周血T淋巴细胞亚群分类比例进行统计学分析。进一步将有效组患儿根据CD4+/CD8+比值分为3组:比例正常组,比例倒置组及比例超高组,分别将该3组CD4+/CD8+比值与治疗无效组进行比较,并进行统计学分析。结果免疫抑制治疗有效组与免疫抑制治疗无效组比较,有效组中CD4+/CD8+比例倒置及超高患儿与无效组比较差异有统计学意义;二组治疗前外周血T淋巴细胞亚群分类中CD8+CD28+及CD8+CD28-细胞比例差异有统计学意义,治疗有效组患儿CD8+CD28+/CD8+CD28-比值显著高于治疗无效组。结论急性AA患儿治疗前外周血T淋巴细胞亚群CD8+CD28+/CD8+CD28-细胞比例对预测免疫抑制治疗效果具有一定的临床意义。可有针对性的为急性AA患儿选择治疗方案提供参考依据。Objective To explore the therapeutic effect of acute aplastic anemia（AA） with immunosuppressive therapy（IST） in children and the relationship between therapeutic effect and peripheral T-lymphocyte subset proportions before treatment.Methods Forty-three pediatric acute AA hospitalized in Southern Hospital of Southern Medical University and treated with IST during 2000 to 2007 were stu-died retrospectively.Patients were divided into the responding and the non-responding group according to the effect of treatment.Ratios of peripheral T-lymphocyte subset of both groups before treatment were analyzed statistically.Then the responding group was further divided into 3 groups according to the levels of CD4^＋/CD8^＋： normal level group,lower level group and super high level group.And the levels of the 3 groups were compared with non-responding group′s data,respectively and analyzed statistically.Results Comparing responding group and non-responding group,there were significant differences among responding group with higher and lower CD4^＋/CD8^＋ ratios;and before treatment,there was significant difference of CD8^＋CD28^＋/CD8^＋CD28^-ratio between 2 groups.CD8^＋CD28^＋/CD8^＋CD28^-ratio in responding group was higher than that in non-responding group.Conclusions Pediatric acute AA patients′ peripheral T-lymphocytes subset CD4^＋CD28^＋/ CD8^＋CD28^-ratio before IST treatment has certain clinical importance on predicting the prognosis of IST.It can more specifically provide reference for clinician to choose therapy.

关 键 词：再生障碍性贫血 免疫抑制治疗 T淋巴细胞亚群 

分 类 号：R725.5[医药卫生—儿科]