成人急性白血病患者外周血T细胞亚群、NK细胞动态监测  

Dynamic monitoring of T lymphocyte subsets and NK cells in peripheral blood among adult AL patients

作　　者：张玉玲 梁艳[2] 俞钟 林传明[2] 李海亮[2] ZHANG Yu-ling;LIANG Yan;YU Zhong;LIN Chuan-ming;LI Hai-liang(The First People's Hospital of Nankang District;Department of Hematology,the First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]南康区第一人民医院肿瘤血液科 [2]赣南医学院第一附属医院血液科,江西赣州341000

出　　处：《赣南医学院学报》2020年第1期40-44,61,共6页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:通过流式细胞仪检测成人AL患者初诊时、多次化疗后T细胞亚群、NK细胞的百分比及数量,探索T细胞亚群、NK细胞与AL发生、化疗次数的关系。方法:实验组为成人AL患者共47例,对照组为22例健康体检者。采用BD FACS Calibur型流式细胞仪检测T细胞亚群、NK细胞的百分比;采用XN2000全自动血液分析仪进行淋巴细胞计数,然后乘以流式细胞仪所检测的T细胞亚群、NK细胞百分比。结果:NK细胞数量与化疗次数呈负相关(P<0.05)。T细胞百分比与化疗次数呈正相关(P<0.05)。CD8^+T细胞百分比与化疗次数呈正相关(P<0.05)。成人AL患者初诊时、未缓解时、多次(第1至第5次)化疗后外周血NK细胞百分比、NK细胞数量、CD8+T细胞百分比、DPT细胞百分比低于健康人群(P<0.05)。成人AL患者初诊时、多次(第1至第5次)化疗后、健康对照组外周血NK细胞百分比均高于成人急性白血病未缓解患者(P<0.05)。结论:成人急性AL患者初诊时、未缓解时NK细胞百分比及数量减少,多次(第1至第5次)化疗后仍未恢复正常水平;从第2至第5次化疗后外周血T细胞百分比上升,T细胞亚群表达水平紊乱,提示成人急性白血病患者化疗前后均存在免疫功能紊乱。Objective:To detect T lymphocyte subsets and NK cells amount and percentage by flow cytometry(FCM)at diagnosis and after several courses for chemotherapy in peripheral blood among adult AL patients;To explore relationship between T lymphocyte subsets and NK cells and AL occurrence and the number of course for chemotherapy.Methods:Experimental group was 47 adult AL patients;control group was 22 healthy subjects.Detecting percentage of T lymphocyte subsets and NK cells in peripheral blood by BD FACS Calibur flow cytometry.We detected lymphocyte cells by Sysmex XN2000 fully automatic hematology analyzer,then the number of lymphocyte numbers multiplied by the percentage of flow cytometry,gettting the amount of T lymphocyte subsets and NK cells.Results:There was a negative correlation between NK cell and the number courses for chemotherapy(P<0.05).T cell percentage and the number courses for chemotherapy was positively correlated(P<0.05).CD8+T cell percentage and the number courses for chemotherapy was positively correlated(P<0.05).When adult AL patients at diagnosis,after several courses chemotherapy(first to fifth)and with NR NK cell percentage,NK cell quantity,CD8^+T cell percentage,DPT cell percentage were decreased significantly than those in normal control(P<0.05).When adult AL patients at diagnosis,after several courses chemotherapy(first to fifth)and normal control NK cell percentage were higher than those with NR of AL(P<0.05).Conclusions:When adult AL patients at diagnosis and with NR,NK cell is in immunodeficiency state,which NK cell percentage and quantity decrease.After several chemotherapy(first to fifth),NK cell percentage and quantity cannot return to normal level among adult AL patients;peripheral blood T cell percentage grew from second chemotherapy to fifth chemotherapy,but T lymphocyte subsets expression level was disorderly,suggesting that adult AL patients exist immune dysfunction before and after chemotherapy.

关 键 词：白血病 淋巴细胞 T细胞亚群 NK细胞 

分 类 号：R733.71[医药卫生—肿瘤]