慢性淋巴细胞白血病外周血T细胞亚群及免疫球蛋白研究

 目的　分析慢性淋巴细胞白血病（CLL）患者的免疫状态及其与疾病分期的关系。方法　应用流式细胞术（FCM）分析60例B-CLL患者外周血T淋巴细胞亚群的变化，用免疫速率比浊法分析其中37例患者血清中IgG、IgA和IgM的变化，比较各Binet分期患者免疫功能的变化。结果　与正常对照组相比，60例B-CLL患者外周血中CD+3、CD+4和CD+8细胞比率均明显降低（P＜0.01），Binet B、C期组患者CD+4／CD+8比值也明显低于Binet A和正常对照组（P＜0.01）。37例B-CLL患者中有21例患者（56.8 %）出现有免疫球蛋白（Ig）减低的情况。Binet C期组Ig减低发生率高于Binet A和B期（P＜0.05），Binet C期组IgG、IgA、IgM的平均水平明显低于Binet A和B期组（P＜0.05）。结论　CLL患者存在细胞免疫和体液免疫功能的低下，与CLL病程密切相关。检测CLL患者外周血T细胞亚群及Ig水平的变化，对了解CLL免疫功能状态，从而判断病情具有重要作用。

T lymphocyte subsets and immunoglobulin state in peripheral blood of patients with chronic lymphocytic leukemia

Objective　To evaluate the immune state and its relationship with Binet stages in patients with chronic lymphocytic leukemia (CLL). Methods　The peripheral blood T lymphocyte subsets were detect－ed by flow cytometry (FCM) in 60 patients with B-CLL, and immunoglobulin (Ig) was detected by immunotur－bidimetry in 37 cases. Results　The levels of CD+3, CD+4, CD+8 were depressed more significantly in Binet A,B,C stages of CLL as compared with healthy controls (P <0.01), and CD+4／CD+8 was decreased more significantly in Binet B、C stages as compared with Binet A stage and healthy controls (P <0.01). The levels of Ig were de－pressed in 21 out of 37 patients (P <0.05), and lower significantly in Binet C stage than that in Binet A and B stages (P <0.05). Conclusion　Immune functions, including the levels of CD+4／CD+8 and Ig, were depressed in CLL patients, and related to Binet stages. The analysis of lymphocyte subsets and Ig were helpful to evaluate the severity in CLL.