急性髓性白血病患者外周血 T 淋巴细胞亚群及 Th1/Th2细胞因子的变化及其临床意义

摘要

Objective To evaluate the change and clinical significance of T - lymphocyte subsets and Th1 / Th2 cytokines in peripheral blood of patients with acute myeloid leukemia( AML). Methods The flow cytometry instrument and enzyme - linked immunosorbent assay (Elisa)was used respectively to detect the T - lymphocyte subsets and Th1 / Th2 cytokines of 50 cases of healthy subjects and 30 cases of AML pa-tients before and after treatment. Results Before treatment,the peripheral blood CD3 + ,CD4 + and CD4 + / CD8 + in AML patients were signifi-cantly lower than healthy group,CD8 + was significantly higher than healthy group,the difference statistically significant( P ﹤ 0. 05). After treat-ment,peripheral blood in patients with AML group CD3 + ,CD4 + and CD4 + / CD8 + were significantly increased,CD8 + decreased significantly, compared with before treatment was statistically significant( P ﹤ 0. 05),but the difference was statistically significant compared with healthy group( P ﹤ 0. 05). Before treatment,the peripheral blood IL - 2 and IFN - γ in AML patients were significantly lower than healthy group. IL -4 and IL - 10 were significantly higher than healthy group,the difference statistically significant( P ﹤ 0. 05). After treatment,IL - 2 and IFN -γ of peripheral blood in patients with AML group were significantly increased,IL - 4 and IL - 10 decreased significantly compared with before treatment. The difference was statistically significant compared with healthy group( P ﹤ 0. 05). Conclusion T - lymphocyte subsets and Th1 /Th2 cytokines may be effective index to evaluate the prognosis of patients with AML. To regulate T lymphocyte subsets and Th1 / Th2 cytokine im-munotherapy program,this method may provide new ideas for the clinical treatment of AML.%目的：探讨急性髓性白血病（AML）患者外周血 T 淋巴细胞亚群及 Th1/ Th2细胞因子的变化及临床意义。方法采用流式细胞仪及酶联免疫吸附法（ELISA）分别检测50例健康者及30例 AML 患者治疗前后 T 淋巴细胞亚群及 Th1/ Th2细胞因子水平。结果初诊 AML 患者外周血 CD3+、CD4+、CD4+/ CD8+均显著低于健康组，CD8+显著高于健康组，差异具有统计学意义（ P ﹤0.05）。治疗后，AML 组患者外周血 CD3+、CD4+、CD4+/ CD8+均显著升高，CD8+显著降低，与初诊时比较差异具有统计学意义（ P ﹤0.05），但与健康组比较差异仍具有统计学意义（ P ﹤0.05）。初诊AML 患者外周血白介素2（IL -2）、干扰素（IFN -γ）均显著低于健康组，IL -4、IL -10显著高于健康组，差异具有统计学意义（ P ﹤0.05）。治疗后，AML 组患者外周血 IL -2、IFN -γ均显著升高，IL -4、IL -10显著降低，与初诊时比较差异具有统计学意义（ P ﹤0.05），但与健康组比较差异仍具有统计学意义（ P ﹤0.05）。结论 T 淋巴细胞亚群及 Th1/Th2细胞因子对 AML 患者病情评估、疗效判定及预后评估具有一定临床价值。以调节 T 淋巴细胞亚群及 Th1/ Th2细胞因子为免疫治疗方案，可能为 AML 的临床治疗提供新思路。