再生障碍性贫血患者骨髓T细胞亚群与免疫抑制治疗疗效的关系  

Relationship between the changes of T-cell subgroups in the bone marrow of patients with aplastic anemia and the effects of immunosuppressive therapy

作　　者：徐淑芬[1] 白海[1] 王存邦[1] 欧剑锋[1] 杨小亮[1] 陆井之[1] 

机构地区：[1]兰州军区兰州总医院血液科,甘肃兰州730050

出　　处：《西北国防医学杂志》2010年第6期401-403,共3页Medical Journal of National Defending Forces in Northwest China

基　　金：甘肃省自然科学基金资助项目(ZS001-A23-082-Y)

摘　　要：目的:探讨再生障碍性贫血(再障)患者骨髓T细胞亚群的变化及其与再障免疫抑制治疗疗效之间的关系。方法:48例分别接受常规和常规联合免疫抑制治疗,采用流式细胞术检测骨髓T细胞亚群及CD4+/CD8+比值,将患者分为比值正常型和比值倒置型2个免疫亚型,分析和比较各亚型与疗效之间的关系。结果:总有效率为62.5%(29/48),常规治疗组有效率(43.2%)显著低于免疫抑制剂治疗组(72.2%,P<0.05),比值倒置型患者采用免疫抑制治疗时其总有效率(89.3%)显著高于常规治疗组(46.4%,P<0.05)。结论:再障患者存在CD4+/CD8+比值失调,其发病与免疫异常密切相关。Objective： To explore the relationship between the changes of T-cell subgroups in the bone marrow （ BM） of patients with aplastic anemia（ AA） and the effects of immunosuppressive therapy . Methods： T - cell subgroup and the ratio of CD4 ＋ /CD8 ＋ cell in the BM of 48 AA patients who had been clearly diagnosed and given the conventional therapy or the conventional therapy combined with immunotherapy were analyzed by multiparameter flow cytometry. The patients with AA were divided into normal type of ratio and inverted type of ratio,and then the relations of these subgroups with patients’conditions and therapeutic effects were investigated. Results： Total therapeutic efficacy in these patients was 62. 5% （ 29 /48） . In the conventional therapy group,the therapeutic efficacy was lower than that in combined immunotherapy group （ 43. 2% vs 72. 2% ,P 0. 05） . In combined immunotherapygroup,the therapeutic efficacy of inverted type of ratio subgroup was more than that in the conventional therapy group （ 89. 3% vs 46. 4% ,P 0. 05） . Conclusion： The majority of AA patients have abnormal ratios of CD4 ＋ /CD8 ＋ ,and immunologic abnormality may play a role in the pathogenesis .

关 键 词：再生障碍性贫血 免疫异常 T细胞亚群 CD4 CD8 

分 类 号：R556.5[医药卫生—血液循环系统疾病]