T细胞亚群在重型再生障碍性贫血治疗中的疗效预测价值  

Efficacy Prediction of T cell Subsets in Kidney-Supplementing Medicinal Combined with Anti-Lymphocyte Globulin/Anti-Thymocyte Globulin for Severe Aplastic Anemia

作　　者：唐旭东[1] 张姗姗[1] 许勇钢[1] 杨晓红[1] 李柳[1] 刘锋[1] 麻柔[1] 

机构地区：[1]中国中医科学院西苑医院,北京市海淀区西苑操场1号100091

出　　处：《中医杂志》2013年第20期1755-1758,共4页Journal of Traditional Chinese Medicine

摘　　要：目的探讨CD3+HLA-DR+T和CD3+CD25+T细胞亚群在以补肾中药联合抗淋巴细胞球蛋白/抗胸腺细胞球蛋白(ALG/ATG)为主治疗重型再生障碍性贫血(简称重型再障)中的疗效预测价值。方法采用补肾中药联合ALG/ATG对71例重型再障患者进行治疗,辅以环孢菌素A、雄激素、造血生长因子等,检查重型再障患者治疗前后CD3+HLA-DR+T和CD3+CD25+T细胞亚群的免疫学指标变化。结果重型再障经补肾中药联合ATG/ALG治疗后,有效患者(59例)的CD3+CD25+T较无效患者(12例)明显升高(P<0.05),CD3+HLA-DR+T、CD3+HLA-DR+T/CD3+CD25+T与重型再障的疗效无明显相关性(P>0.05)。经过Kaplan-Meier过程,CD3+HLA-DR+T细胞比例>7%时,CD3+CD25+T细胞比例>3%时,CD3+HLA-DR+T/CD3+CD25+T细胞≤2.5时患者生存期较长(P<0.05)。结论 CD3+CD25+T可作为重型再障疗效预测性指标,其升高提示疗效较佳;CD3+HLA-DR+T细胞比例>7%、CD3+CD25+T细胞比例>3%、CD3+HLA-DR+T/CD3+CD25+T细胞≤2.5提示预后较好,生存期较长。Objective To study the efficacy prediction of CD3^＋ HLA-DR＋ T and CD3^＋ CD25＋ T cell subsets in kidney- supplementing medicinal combined with anti-lymphocyte globulin/anti thymocyte globulin （ALG/ATG） for severe aplastic anemia （SAA）. Methods Totally 71 cases of SAA were given the combo therapy of kidney-supplementing medicinal, ALG/ ATG, Cyclosporin A, androgens and hematopoietic growth factors. The percentages of CD3^＋ HLA-DR^＋ T and CD3^＋ CD25^＋T were detected before and after treatment. Results The percentage of CD3^＋ CD25^＋ T was significantly increased in the effective cases after treatment （P〈0.05）. There was no significant difference between the therapeutic effect and the percentage of CD3^＋HLA-DR^＋T and CD3^＋ HLA-DR^＋ T/CD3^＋ CD25^＋ T （P〉0.05.）. The survival was prolonged when the percentage of CD3^＋ HLA-DR^＋T exceeded 7% （P〈0.05）, the percentage of CD3^＋CD25^＋T exceeded 3G （P〈0.05） and CD3^＋ HLA-DR^＋ T/CD3^＋CD25^＋T was less than or equal to 2. 5 （P〈0.05） after Kaplan-Meier procedure. Conclusion The percentage of CD3^＋ CD25^＋ T can be taken as the indicator of efficacy prediction and its exaltation suggests a better efficacy. The survival is prolonged when the percentage of CD3^＋ HLA-DR^＋ T exceeds 7%, the percentage of CD3^＋ CD25^＋ T exceeds 3% and CD3^＋ HLA-DR^＋ T/CD3^＋ CD25^＋ T is less than or equal to 2.5.

关 键 词：再生障碍性贫血 补肾 抗淋巴细胞球蛋白 抗胸腺细胞球蛋白 T淋巴细胞亚群 疗效预测 

分 类 号：R556[医药卫生—血液循环系统疾病]