慢性再生障碍性贫血病儿治疗前后免疫功能的变化

①目的研究慢性再生障碍性贫血（CAA）病儿治疗前后免疫功能的变化及其临床意义。②方法采用流式细胞仪检测23例CAA病儿治疗前后及35例正常对照组儿童外周血CD3^＋、CD4^＋、CD8^＋、CD19^＋、NK细胞等的含量；采用ELISA法检测IgA、IgG、IgM的含量。③结果CAA病儿治疗前后CD4^＋细胞含量及CD4^＋／CD8^＋比值均明显低于正常对照组，差异有极显著性（t或t′=2．52～5．35，P〈0．01）；CD8^＋、NK细胞含量均较正常对照组增高，差异有极显著性（t或t′=3．15～9．15，P〈0．01）；治疗前后各指标差异均无显著性（t=0．84～1．55，P〉0．05）；治疗前后CD19^＋、CD3^＋细胞含量较正常对照组无显著性差异（t或t′=0．38～1．15，P〉0．05）．外周血IgG、IgA、IgM含量较正常对照组无显著性差异（t或t′=0．38～1．77，P〉0．05）。④结论CAA病儿以细胞免疫异常为主，经治疗后免疫功能仍未完全恢复；免疫治疗应坚持长期足量的原则。

CHANGES OF IMMUNOLOGICAL FUNCTION IN CHILDREN WITH CHRONIC APLASTIC ANEMIA BEFORE AND AFTER TREATMENT

Objective To investigate the changes of immunological function in children with chronic aplastic anemia(CAA). Methods The content of CD3~+CD4~+CD8~+CD19~+NK cells were detected in peripheral blood of 23 CAA children and 35 healthy children. The contents of IgA, IgG, and IgM were also detected with ELISA. Results The contents of CD4~+ and CD4~+/CD8~+ of the CAA group were all significantly lower than those of the control group(t or t=2.52-5.35, P<(0.01)). The contents of CD8~+ and NK cells were higher than those of control group (t or t=3.15-9.15, P<0.01). There was no significant difference in the contents of CD3~+ or CD19~+ (t or t=0.38-1.15,P>0.05); nor in IgA, IgG, or IgM between the two groups ((t or t=)0.38-1.77, P>0.05). Conclusion CAA children showed mainly abnormal cellular immunity. The immunological function of patients in this group did not fully recover after treatment. The principle of long-term and sufficient immunotherapy should be maintained for aplastic anemia.