CAJ | 학술논문

目的：研究 CD4+CD25+CD127 low/-调节性 T 细胞(Treg)和淋巴细胞亚群在急性髓系白血病(AML)患者外周血中的变化、相互关系及临床意义。方法采用流式细胞仪对初治组和完全缓解( CR)组外周血Treg及淋巴细胞亚群水平进行检测，并与正常对照组进行对比。结果初治组和CR组AML患者外周血中Treg水平均高于正常对照组( P<0．05)，初治组高于CR组(P<0．05)。初治组和CR组AML患者外周血的NK( CD3-CD16+CD56+)细胞占淋巴细胞的比例均低于正常对照组(P<0．05)，初治组低于CR组(P<0．05)。初治组 CD3+ T 细胞、CD4+ T 细胞含量和 CD4+/CD8+比值均低于正常对照组( P<0．05)，但初治组CD8+T细胞含量却明显高于正常对照组( P<0．05)；CR组CD3+T细胞、CD4+T细胞、CD8+T细胞含量及CD4+/CD8+比值接近正常对照组，与初治组比较差异有统计学意义(P <0．05)。结论 AML患者外周血中Treg及CD8+T细胞比例明显升高， NK 细胞、CD3+ T 细胞、CD4+ T 细胞含量和CD4+/CD8+比值降低，表明AML患者免疫功能处于抑制状态。 Treg控制CD8+T细胞免疫应答，同时抑制NK细胞的天然免疫反应，在CD4+T细胞与CD8+T细胞平衡的失调中起主要作用，与 AML 疾病发生发展密切相关。通过下调Treg的数量或去除其抑制功能，优化AML患者的免疫治疗。
목적：연구 CD4+CD25+CD127 low/-조절성 T 세포(Treg)화림파세포아군재급성수계백혈병(AML)환자외주혈중적변화、상호관계급림상의의。방법채용류식세포의대초치조화완전완해( CR)조외주혈Treg급림파세포아군수평진행검측，병여정상대조조진행대비。결과초치조화CR조AML환자외주혈중Treg수평균고우정상대조조( P<0．05)，초치조고우CR조(P<0．05)。초치조화CR조AML환자외주혈적NK( CD3-CD16+CD56+)세포점림파세포적비례균저우정상대조조(P<0．05)，초치조저우CR조(P<0．05)。초치조 CD3+ T 세포、CD4+ T 세포함량화 CD4+/CD8+비치균저우정상대조조( P<0．05)，단초치조CD8+T세포함량각명현고우정상대조조( P<0．05)；CR조CD3+T세포、CD4+T세포、CD8+T세포함량급CD4+/CD8+비치접근정상대조조，여초치조비교차이유통계학의의(P <0．05)。결론 AML환자외주혈중Treg급CD8+T세포비례명현승고， NK 세포、CD3+ T 세포、CD4+ T 세포함량화CD4+/CD8+비치강저，표명AML환자면역공능처우억제상태。 Treg공제CD8+T세포면역응답，동시억제NK세포적천연면역반응，재CD4+T세포여CD8+T세포평형적실조중기주요작용，여 AML 질병발생발전밀절상관。통과하조Treg적수량혹거제기억제공능，우화AML환자적면역치료。
Objective To explore the alterations, relationship and clinical significance of CD4 +CD25 +CD127 low/ - <br> regulatory T cells ( Treg ) and lymphocyte subsets in peripheral blood of patients with acute myelocytic leukemia ( AML) . Methods The level of peripheral blood lymphocyte subsets and Treg of untreated AML patients and com-plete remission( CR) patients were tested by flow cytometry,and were compared with that of 30 normal controls. Re-sults The proportions of Treg were much higher in untreated AML patients and CR patients than in normal con-trols, while the mean proportion of Treg in untreated AML patients was higher than that in CR patients(P<0. 05). The proportions of NK( CD3 -CD16 +CD56 +) cells in untreated AML patients and CR patients were both decreased compared with normal controls,and the mean proportion of NK cells in untreated AML patients was lower than that in CR patients(P<0. 05). Compared with the normal controls,the proportions of CD3 +T cell, CD4 +T cell,and the ratio of CD4 +/CD8 + decreased in untreated AML patients ( P <0. 05 ) , but the proportions of CD8 +T cell was higher than in normal controls;the proportions of CD3 +T cell, CD4 + T cell, CD8 +T cell and the ratio of CD4 +/CD8 + in CR patients were close to the proportions in normal controls, but there was significant difference between CR patients and untreated AML patients(P<0. 05). Conclusion The increase of Treg, CD8 +T cell and decrease of NK cells, CD3 +T cell, CD4 +T cell, and the ratio of CD4 +/CD8 + in peripheral blood of patients with AML in-dicate that the immune function of patients with AML is depressed. Treg control the immune response of CD8 +T cells,at the same time inhibit the natural immune response of NK cells, playing a major role in the disorders of CD4 +T cells and CD8 +T cell balance,and closely relate with the development of AML. The immune treatment of patients with AML will be optimised by reducing the amount of Treg or removing the suppression function.