急性白血病患者外周血T淋巴细胞亚群及NK细胞水平检测及临床意义.doc

急性白血病患者外周血T淋巴细胞亚群及NK细胞水平检测及临床意义 　 作者：吴朝阳, 吴雅荣, 王法春, 陈巧云, 季勇慧 钱震 杨小飞 盛晓静 张永宁, 钱军 【摘要】 目的： 研究急性白血病患者外周血T淋巴细胞亚群、NK细胞水平变化及临床意义。方法： 采用流式细胞仪对32例急性白血病患者 (急性髓细胞性白血病23例、急性淋巴细胞性白血病9例)及18例正常人外周血T淋巴细胞亚群及NK细胞水平进行检测。结果： 初治急性白血病组与正常对照组比较，CD3+细胞、CD4+细胞、CD4+/CD8+比值及NK细胞下降（Plt;0.05），CD8+细胞略升高（Pgt;0.05）。化疗后12例取得完全缓解，再次检测上述指标接近正常对照组（Pgt;0.05）。初诊急性淋巴细胞性白血病组CD4+细胞及CD4+/CD8+比值低于初诊急性髓细胞性白血病组（Plt;0.05）。结论： 急性白血病患者细胞免疫功能明显异常。与急性髓细胞性白血病相比，急性淋巴细胞性白血病细胞免疫功能更为低下。T细胞亚群及NK细胞水平检测在评价急性白血病疗效及判断预后方面具有一定的临床价值。 【关键词】 急性白血病； T细胞亚群； NK细胞 ［Abstract］ Objective: To study the changes of T lymphocyte subsets，NK cells in peripheral blood of patients with acute leukemia and its clinical significance.Methods： The different level of peripheral blood T lymphocyte subsets, NK cells of 32 acute leukemia patients and 18 normal controls were detected with flow cytometry. Results： Compared with the normal controls, the number of CD3+ T cell, CD4+T cell, NK cell and CD4+/CD8+ ratio reduced in newly diagnosed acute leukemia group(Plt;0.05), while those of CD8+ T cell slightly increased(Pgt;0.05).Twelve of 32 patients achieved complete remission after chemotherapy.Their level of T lymphocyte subsets，NK cells near those of normal controls（Pgt;0.05）.The number of CD3+ T cell and CD4+/CD8+ ratio in newly diagnosed acute lymphoblastic leukemia group were lower than those in newly diagnosed acute myelogenous leukemia group(Plt;0.05). Conclusion： Cellular immune function is significantly abnormal in patients with acute leukemia.Compared with acute myelogenous leukemia, patients with acute lymphoblastic leukemia had more poor cellular immune function.Detection of T lymphocyte subsets，NK cells are clinically value on evaluation of therapeutic effect and prognosis of acute leukemia. ［Key words］ acute leukemia; T lymphocyte subsets; NK cell 急性白血病（acute leukemia,AL）是造血干细胞的恶性克隆性疾病，其发生及发展与机体免疫紊乱有着密切的关系。在抗肿瘤免疫效应中,细胞免疫比体液免疫起着更为重要的作用。T淋巴细胞和NK细胞执行细胞免疫功能，是机体抗肿瘤免疫的重要活性细胞。本文采用流式细胞术（flowcytometry,FCM）检测急性白血病患者及健康人群外周血T淋巴细胞