ALL和N-ALL白血病患者治疗前后外周血T淋巴细胞亚群和免疫球蛋白变化及其对病情监测和预后判断的价值  

Changes of T Lymphocyte Subsets and Immunoglobulin in Peripheral Blood of Patients with ALL and N-ALL before and after Treatment and their Value for Monitoring of Disease and Evaluation of Prognosis

作　　者：朱琼媛 甸自金[2] 周玉国 赵珠 张之 张馨予 杨宝瑞 

机构地区：[1]云南省第二人民医检验科,云南昆明650021 [2]云南省第一人民医院检验科,云南昆明650032

出　　处：《中国实验血液学杂志》2018年第1期136-140,共5页Journal of Experimental Hematology

摘　　要：目的:分析急性淋巴细胞性白血病(ALL)与非急性淋巴细胞性白血病(N-ALL)患者治疗前后外周血T淋巴细胞亚群和免疫球蛋白变化及其对病情监测和预后判断的价值。方法:选取本院106例白血病患者,其中ALL患者48例(ALL组),N-ALL患者58例(N-ALL组),并同期选择在本院健康体检的人员54例为正常对照组。对各组外周血免疫球蛋白IgA、IgG和IgM进行检测,并通过细胞生物玻片法对其T淋巴细胞亚群绝对值进行测定。按照治疗后有无改善将106例患者又分为非改善组55例(其中ALL患者25例,N-ALL患者30例)与改善组51例(其中ALL患者23例,N-ALL患者28例)。结果:106例白血病患者IgA、IgG和IgM的水平均显著低于对照组(P<0.05),其外周血CD3^+、CD3^+CD4^+/CD3^+CD8^+比值与CD3^+CD4^+T细胞绝对值均显著低于对照组(P<0.05);CD3^+CD8^+T细胞绝对值与对照组比较无明显差异(P>0.05)。治疗后改善组IgA、IgG和IgM均较治疗前显著提高(P<0.05),与对照组比较无明显差异(P>0.05);外周血CD3^+、CD3^+CD4^+/CD3^+CD8^+比值与CD3^+CD4^+T细胞绝对值也较治疗前显著提高(P<0.05),与对照组比较无明显差异(P>0.05)。相比治疗前,治疗后未改善组各项指标均无明显差异(P>0.05),而且CD3^+、CD3^+CD4^+/CD3^+CD8^+比值和CD3^+CD4^+T细胞绝对值均显著低于对照组(P<0.05),而CD3^+CD8^+T细胞绝对值均较对照组高(P<0.05)。结论:治疗后ALL和N-ALL患者外周血T淋巴细胞亚群(CD3^+、CD3^+CD4^+T细胞)与免疫球蛋白(IgA、IgG、IgM)的水平明显改善,对各项指标进行检测有助于病情监测和预后评估。Objective： To study the changes of T lymphocyte subsets and immunoglobulin in peripheral blood of patients with acute lymphoblastic leukemia（ ALL） and non-acute lymphocytic leukemia（ N-ALL） before and after treatment and their value for monitoring of disease and evaluation of prognosis. Methods： One hundred and six cases of leukemia were selected in our hospital,including 48 cases of ALL（ ALL group） and 58 cases of N-ALL（ N-ALL group）; 54 peoples of normal physical examination were selected as the normal control group in the same period. The IgA,IgG and IgMlevels of peripheral blood were detected,and the absolute value of T lymphocyte subsets was determined by cell slide method. According to whether the patients＇ status was improved or not by treatment,the 106 patients were divided into the unimproved group（ 55 cases including 25 ALL,30 N-ALL） and improved group（ 51 cases including 23 ALL,28 N-ALL）. Results： The levels of IgA,IgG and IgMin 106 cases of leukemia were significantly lower than those in the control group（ all P〈0. 05）,and the CD3^＋level,CD3^＋CD4^＋/CD3^＋CD8^＋ratio and the absolute value of CD3^＋CD4^＋T cells in the peripheral blood were significantly lower than those in the control group（ all P〈0. 05）; the absolute value of CD3^＋CD8^＋T cells showed no significant difference in comparison with the control group（ P〉0. 05）. After treatment,IgA,IgG and IgMlevels in the improved group were significantly higher than those before therapy（ all P〈0. 05）,while their levels were not significantly different from that in the control group（ all P〉0. 05）; the CD3^＋level,CD3^＋CD4^＋/CD3^＋CD8^＋ratio and the absolute value of CD3^＋CD4^＋T cells in the peripheral blood were significantly higher than those before therapy（ all P〈0. 05）,while those were not significantly different from the control group（ all P〉0. 05）. Compared with levels before treatment,the levels of above mentioned indicators in the unimproved group af

关 键 词：ALL白血病 N-ALL白血病 T淋巴细胞亚群 外周血 免疫球蛋白 病情检测 预后判断 

分 类 号：R733.7[医药卫生—肿瘤]