白血病治疗前后CD3^+、CD3^+CD4^+、CD3^+CD8^+T细胞的变化及意义  

Changes of CD3^+,CD3^+CD4^+ and CD3^+CD8^+T lymphocytes before and after treatment in patients with leukemia and their significance

作　　者：原永明 程丽 张舒 彭贤聪 璩斌[3] 

机构地区：[1]上海市徐汇区大华医院检验科,上海200237 [2]上海汇中细胞生物科技有限公司,上海201615 [3]上海交通大学医学院附属瑞金医院检验科,上海200025

出　　处：《检验医学》2016年第5期387-391,共5页Laboratory Medicine

摘　　要：目的探讨白血病患者治疗前后外周血T淋巴细胞亚群(CD3^+、CD3^+CD4^+、CD3^+CD8^+T细胞)的变化及临床价值。方法采用细胞生物玻片法检测100例白血病患者[急性淋巴细胞性白血病(ALL)45例,非急性淋巴细胞性白血病(N-ALL)55例]及90名健康体检者(正常对照组)外周血T淋巴细胞亚群绝对值,同时检测免疫球蛋白Ig G、Ig A、Ig M。根据治疗后是否缓解将白血病患者分为缓解组(48例,其中ALL 21例、N-ALL 27例)和未缓解组(52例,其中ALL 24例、N-ALL 28例)。结果 ALL组及N-ALL组外周血CD3^+、CD3^+CD4^+T细胞绝对值、CD3^+CD4^+/CD3^+CD8^+比值及Ig G、Ig A、Ig M水平均明显低于正常对照组(P<0.05);CD3^+CD8^+T细胞绝对值均稍高于正常对照组,但差异均无统计学意义(P>0.05)。无论是ALL还是N-ALL,治疗后缓解组CD3^+、CD3^+CD4^+T细胞绝对值、CD3^+CD4^+/CD3^+CD8^+比值及Ig G、Ig A、Ig M水平明显高于治疗前(P<0.05),接近于正常对照组(P>0.05);而未缓解组各项指标与治疗前比较差异无统计学意义(P>0.05)。结论检测T淋巴细胞亚群(CD3^+、CD3^+CD4^+、CD3^+CD8^+T细胞)绝对值对白血病患者的病情监测及预后判断具有一定的意义。Objective To investigate the changes of T lymphocyte subsets（CD3~＋,CD3~＋CD4~＋,CD3~＋CD8~＋T cells） in peripheral blood before and after treatment in patients with leukemia and their significance. Methods Semi Bio Slide assay was used to determine 100 leukemia patients [45 cases of acute lymphoblastic leukemia（ALL） and 55 cases of non-acute lymphoblastic leukemia（N-ALL）] and 90 healthy subjects（healthy control group） for peripheral blood T lymphocyte subsets as absolute value. Simultaneously,Ig G,Ig A and Ig M were determined. According to remission after treatment,the patients with leukemia were classifi ed into remission group（48 cases,21 cases of ALL and 27 cases of N-ALL） and non-remission group（52 cases,24 cases of ALL and 28 cases of N-ALL）. Results In ALL group and N-ALL group,peripheral blood CD3~＋and CD3~＋CD4~＋T cell absolute values,CD3~＋CD4~＋/CD3~＋CD8~＋ratio,Ig G,Ig A and Ig M levels were signifi cantly lower than those in healthy control group（P〈0.05）. CD3~＋CD8~＋T cell absolute values were slightly higher than those in healthy control group,but there was no statistical signifi cance（P〉0.05）. Whether it is ALL or N-ALL,after treatment, CD3~＋and CD3~＋CD4~＋T cell absolute values,CD3~＋CD4~＋/CD3~＋CD8~＋ratio,Ig G,Ig A and Ig M in remission group was signifi cantly higher than those before treatment（P〈0.05）,which were close to those in healthy control group（P〈0.05）. There was no statistical signifi cance in non-remission group between before and after treatment（P〈0.05）. Conclusions The determination of T lymphocyte subsets（CD3~＋,CD3~＋CD4~＋,CD3~＋CD8~＋T cells） using absolute values has certain signifi cance for disease monitoring and prognosis in leukemia patients.

关 键 词：T淋巴细胞亚群 绝对值 白血病 免疫功能 

分 类 号：R446.63[医药卫生—诊断学]