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本研究通过检测慢性淋巴细胞白血病(CLL)患者外周血中Th17和CD4+CD25+Foxp3+调节性T(Treg)细胞的比率及其平衡关系,探讨其在CLL发病机制中的作用及临床意义。CLL患者根据外周血淋巴细胞计数及治疗情况,分为初发组30例和治疗后缓解组15例,另设健康对照20例。用流式细胞术(FCM)检测CLL患者和健康对照者外周血中T细胞亚群及Th17和CD4+CD25+Foxp3+Treg细胞占CD4+T细胞的比率。结果显示,初发组CLL患者外周血CD3+CD4+T细胞和Th17细胞的比率均明显高于健康对照组(P<0.05),CD3+CD8+T细胞和CD4+CD25+Foxp3+Treg细胞表达率明显低于健康对照组(P<0.05),Th17/Treg细胞比值明显高于健康对照组(P<0.05);缓解组CLL患者Th17细胞比率与健康对照组相当,而CD4+CD25+Foxp3+Treg细胞表达率明显低于健康对照组(P<0.05),Th17/Treg细胞比值明显高于健康对照组(P<0.05);缓解组CLL患者Th17细胞比率显著低于初发组(P<0.05)。结论:CLL患者外周血T细胞紊乱以CD4+T细胞的增加为主,Th17细胞比率增加和CD4+CD25+Foxp3+Treg细胞比率降低导致Th17/Treg细胞比率失衡,该免疫失衡在CLL的发生发展中可能起重要作用。
In this study, we examined the role of Th17 and CD4 + CD25 + Foxp3 + regulatory T (Treg) cells in the peripheral blood of patients with chronic lymphocytic leukemia (CLL) and their relationship to the pathogenesis of CLL and its clinical significance. CLL patients according to peripheral blood lymphocyte count and treatment, divided into initial group of 30 patients and 15 cases of remission after treatment, another set of 20 healthy controls. The percentage of T lymphocyte subsets and Th17 and CD4 + CD25 + Foxp3 + Treg cells in CD4 + T cells in peripheral blood of CLL patients and healthy controls were detected by flow cytometry (FCM). The results showed that the ratio of CD3 + CD4 + T cells and Th17 cells in peripheral blood of patients with primary CLL was significantly higher than that of healthy controls (P <0.05), CD3 + CD8 + T cells and CD4 + CD25 + Foxp3 + Tregs (P <0.05), and the ratio of Th17 / Treg cells was significantly higher than that of healthy controls (P <0.05). The proportion of Th17 cells in CLL patients in remission group was similar to that in healthy controls, while CD4 + CD25 + Foxp3 + (P <0.05), the ratio of Th17 / Treg cells was significantly higher than that of healthy controls (P <0.05); the proportion of Th17 cells in remission group was significantly lower than that of initial group (P <0.05) ). CONCLUSIONS: T cell disorders in peripheral blood of CLL patients are predominately increased by CD4 + T cells. Increased Th17 cell ratio and decreased ratio of CD4 + CD25 + Foxp3 + Treg cells lead to imbalance of Th17 / Treg cell ratio. The immune imbalance occurs in CLL May play an important role.