T细胞亚群检测在儿童自免溶贫患者中应用的意义  

Clinical significance of T cell subsets detection in children with autoimmune hemolytic anemia

作　　者：李正峰 陈鑫 陈萍 段灵 王佳[1] 甘珊 胡红兵 LI Zhengfeng;CHEN Xin;CHEN Ping;DUAN Ling;WANG Jia;GAN Shah;HU Hongbing(Department of blood transfusion, Wuhan children＇s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, China.)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院输血科

出　　处：《中国输血杂志》2018年第5期464-467,F0001,共5页Chinese Journal of Blood Transfusion

摘　　要：目的探讨CD4＋T、CD8＋T淋巴细胞亚群检测及CD4＋T/CD8＋T比值在儿童自身免疫性溶血性贫血疾病过程中的意义。方法对87例来自武汉儿童医院血液科2015—2016年间诊断为自身免疫性溶血性贫血患儿标本进行血常规、网织红细胞检测,应用流式细胞术检测外周血CD4＋T、CD8＋T细胞百分率及CD4＋T/CD8＋T比值,与正常对照组比较;同时比较患者组中抗人球试验阳性组与阴性组之间T细胞亚群结果差异。结果自免溶贫患儿外周血血红蛋白、网织红细胞百分比较正常组均明显异常（P〈0.05）,患者组较组正常对照组外周血CD4＋T细胞占比明显低于正常对照组（P〈0．01），CD8＋T细胞占比增高（P〈0．05）；CD4＋T／CD8＋T比值明显减低（P〈0．01）；患者组内直抗试验阳性（DAT＋）组与直抗试验阴性（DAT-）组在网织红细胞百分比、CD4＋T、CD8＋T百分比和CD4＋T／CD8＋T比值上均无差异（P〉0．05），两组中CD4＋T/CD8＋T比值和网织红细胞百分比均呈负相关（r=-9.167,P=0.009）,（r=-19.542,P=0.001）。结论 CD4＋T/CD8＋T比值异常,可能参与儿童自免溶贫疾病细胞免疫紊乱方面的发病机制,较传统抗球蛋白试验能一定程度上反映患儿病情。Abstract：Objective To discuss the significance of CD4＋ T, CD8＋T lymphocyte subsets detection and CD4＋ T/CD8＋T ratio in the process of autoimmune hemolytic anemia in children. Methods 87 children patients from 2015 to 2016, Department of Hematology, Wuhan Children＇s Hospital with AIHA and healty controls. Automated hematology analyze was used for counting blood cells, Flow cyometry（FC） was used for detected the percentage of CD4＋T,CD8＋T and CD4＋T/CD8＋T cells in follow groups. Results Compared with the normal group, the percentage of peripheral blood hemoglobin and %reticulocyte in the AIHA children patients group was significantly abnormal （P〈 0. 01 ）. The percentage of CD4＋T cells of AIHA children patients group was lower than that of healty control groups（P〈0. 01 ）. The percentage of CD8＋T cells of AIHA children patients group was higher than that of healty control groups（P〈0. 05）. The ratio of CD4＋T/CD8＋T in AHIA group was lower than that of healty control group（P〈0. 01 ）. There were no difference in %reticulocyte, CD4＋T, CD8＋T and CD4＋T/CD8＋T in the patients with DAT＋ group and DAT- group （P〉0. 05）, The percentage of CD4＋T/CD8＋T in the two groups was negatively correlated with the percentage of the reticulocyte （ r = -9. 167, P-= 0. 009）, （ r = - 19. 542, P = 0. 001 ）. Conclution The abnormal ratio of CD4＋T / CD8＋T may be involved in the pathogenesis of cellular immune disorder in children with autoimmune hemolytic anemia, which can reflect the condition of children patients to some extent compared with traditional antiglobulin test.

关 键 词：自身免疫性溶血性贫血(AIHA) 血红蛋白(Hb) 网织红细胞(RET) 流式细胞术 CD4+T细胞 CD8+T细胞 

分 类 号：R725.5[医药卫生—儿科] R446.113[医药卫生—临床医学]