细胞免疫疗法对再生性障碍性贫血患者外周T淋巴细胞的影响

目的 探究细胞免疫治疗重型再生性障碍性贫血(SAA)患者外周T淋巴细胞变化情况。 方法 选取2015年1月-2016年1月在广州市开发区医院治疗的32例重型再生障碍性贫血患者,应用流式细胞术检测细胞免疫治疗前后T淋巴细胞;同时检测血常规各项指标,分析其治疗前后的变化。 结果 32例患者治疗后达到基本治愈及缓解的病人19人,占总数的59.37%;19例治疗有效患者治疗后外周血中性粒细胞(NEU)、 网织红细胞(Ret)、 血小板(PLT)及淋巴细胞(LYM)均较治疗前显著升高(P<0.05); CD4⁺T淋巴细胞(%)在治疗前后无明显改变(P>0.05);CD8⁺T淋巴细胞(%)则显著上调(P<0.05);CD4⁺/CD8⁺ 在治疗前后无明显变化(P>0.05),粒/淋比由原来的(0.85±0.23)升为(1.89±0.57)。 结论 再生性障碍性贫血患者细胞免疫疗法治疗有效患者免疫治疗后粒/淋倒置得到缓解。但 CD4⁺/CD8⁺比例倒置未被纠正。细胞免疫治疗可显著增加CD8⁺T淋巴细胞比例。

Effects of cellular immune therapy on peripheral blood T lymphocytes in aplastic anemia patients

Objective To explore the changes of peripheral blood T lymphocytes before and after the treatment with cellular immunotherapy in severe aplastic anemia (SAA) patients. Methods We selected 32 SAA patients treated in Guangzhou Development District Hospital from January 2015 to January 2016. Flow cytometry was used to detect T lymphocyte before and after receiving cellular immunotherapy, and routine blood indicators were simultaneously determined. The changes of T lymphocytes before and after the treatment were analyzed. Results After the treatment, the basic cure and remission rate of the 32 SAA patients was 59.37% (19/32). After the treatment, peripheral blood neutrophils, reticulated red blood cell, platelet and lymphocyte of the 19 effective cases were significantly increased as compared with those before the treatment (P<0.05). No obvious changes were found in CD4⁺ T lymphocyte (%) and CD4⁺/CD8⁺ before and after the therapy (both P>0.05), while CD8⁺ T lymphocyte (%) was significantly increased (P<0.05). The neutrophil-to-lymphocyte ratio was also increased from (0.85±0.23) to (1.89±0.57). Conclusions As for aplastic anemia patients with effective cellular immunotherapy, the neutrophil-to-lymphocyte ratio is reversed, but no change is observed in the CD4⁺/CD8⁺ ratio. Cellular immunotherapy can significantly increase the proportion of CD8⁺T lymphocytes.