儿童重型β珠蛋白生成障碍性贫血患者外周血淋巴细胞亚群和免疫球蛋白水平状态的研究  

Clinical Signification of Peripheral Blood Lymphocyte Subsets and Serum Immunoglobin Determination in Children with β Thalassemia Major

作　　者：黄映红 林涛 陈卓瑶 HUANG Ying-hong;LIN Tao;CHEN Zhuo-yao(Department of Clinical Laboratory,Guangzhou Municipal Women and Children’Medical Center,Guangzhou 510120,China)

机构地区：[1]广州市妇女儿童医疗中心检验科,广州510120

出　　处：《现代检验医学杂志》2019年第2期23-26,共4页Journal of Modern Laboratory Medicine

基　　金：广东省医学科学技术研究基金(A2017585)

摘　　要：目的研究重型β珠蛋白生成障碍性贫血患儿外周血淋巴细胞各亚群、血清免疫球蛋白(Ig)水平的变化,并探讨其在重型β珠蛋白生成障碍性贫血患儿输血治疗过程中的意义。方法采用流式细胞术(FCM)和免疫比浊法,对45例重型β珠蛋白生成障碍性贫血患儿和50例健康对照组儿童外周血T淋巴细胞亚群(包括CD3^+,CD3^+CD4^+,CD3^+CD8^+和CD4^+/CD8^+)、B淋巴细胞亚群(CD3^-CD19^+)、NK细胞(CD16^+CD56^+)和血清Ig(IgG,IgA和IgM)水平进行检测,两组间进行比较。结果与健康组相比较,重型β珠蛋白生成障碍性贫血患儿CD3^+T细胞比例[(60.49±9.23)%vs (68.41±6.31)%,t=2.46,P=0.005],CD4^+T细胞比例[(31.19±5.02)%vs (43.23±4.52)%,t=3.31,P=0.002],CD4^+/CD8^+比值[(1.19±0.31)%vs (1.73±0.27)%,t=3.78,P=0.001]、NK细胞[(9.27±2.24)%vs (18.04±5.07)%,t=3.92,P=0.001]比例明显减低,差异均具有统计学意义;而CD8^+T细胞比例[(29.11±4.03)%vs (24.49±5.13)%,t=1.89,P=0.04]和CD3^-CD19^+B细胞比例[(26.13±2.99)%vs (12.53±3.11)%,t=4.45,P=0.001]明显增高,差异均具有统计学意义。与此同时,与健康组相比较,重型β珠蛋白生成障碍性贫血患儿血清IgG (13.27±2.31 g/L vs 11.41±1.81 g/L,t=2.93,P=0.011),IgA(1.99±0.43 g/L vs 1.19±0.19 g/L,t=2.69,P=0.043)和IgM(1.91±0.45 g/L vs 1.49±0.27 g/L,t=2.81,P=0.02)水平明显增高,差异均具有统计学意义。结论重型β珠蛋白生成障碍性贫血患儿体内存在着细胞和体液免疫功能紊乱。外周血淋巴细胞亚群和免疫球蛋白水平状态的测定,对监测患儿输血治疗过程中机体免疫功能状态的变化有重要意义。Objective To investigate the changes of peripheral blood lymphocyte subsets and serum immunoglobin(Ig)in children withβthalassemiamajor,and to explore the clinical signification during their course of transfusiontherapy.Methods Peripheral blood lymphocyte subsets including CD3+,CD4+CD8+,CD19+and CD16+CD56+were determined by flow cytometry and serumimmunoglobin levels including IgG,IgA and IgM were detrmined by nethelometry assay in a total of 45 children withβthalassemia major and 50healthy controls were enrolled.The differences between theβthalassemia major group and healthy control group were analyzed statistics.Results Compared with control group,the peripheral blood lymphocyte subsets CD3+,CD3+CD4+,CD3+CD8+and NK cell were significantly decreased inβthalassemia major group[(60.49±9.23)%vs(68.41±6.31)%,t=2.46,P=0.005],[(31.19±5.02)%vs(43.23±4.52)%,t=3.31,P=0.002],[(1.19±0.31)%vs(1.73±0.27)%,t=3.78,P=0.001]and[(9.27±2.24)%vs(18.04±5.07)%,t=3.92,P=0.001],but CD8+and CD19+were significantly increased inβthalassemia major group[(29.11±4.03)%vs(24.49±5.13)%,t=1.89,P=0.04]and[(26.13±2.99)%vs(12.53±3.11)%,t=4.45,P=0.001].Meanwhile,the levels of serum IgG,IgA and IgM inβthalassemia major group(13.27±2.31g/L vs 11.41±1.81g/L,t=2.93,P=0.011),(1.99±0.43g/L vs 1.19±0.19g/L,t=2.69,P=0.043),(1.91±0.45g/L vs 1.49±0.27g/L,t=2.81,P=0.020)were significantly increased.Conclusion The cellular and humeral immune function in children withβthalassemia major were abnormal.The determination of peripheral lymphocyte subsets and immunoglobin should be used to monitor the changes of immune function during their course of transfusion therapy.

关 键 词：儿童 Β珠蛋白生成障碍性贫血 淋巴细胞亚群 免疫球蛋白 免疫功能 

分 类 号：R556.61[医药卫生—血液循环系统疾病] R392.11[医药卫生—内科学]