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目的通过分析CD4+CD25+调节性T细胞(CD4+CD25+regulatory T cells,CD4+CD25+Tregs)在不同病程阶段多发性骨髓瘤(multiple myeloma,MM)患者外周血中的变化和临床意义,初步探讨MM患者的免疫抑制机制。方法流式细胞术检测56例MM患者及30例健康志愿者外周血CD4+CD25+、CD4+CD25high、CD4+CD25+CD127low、CD4+CD25highCD127lowT细胞的比例并分析比较。结果1)56例MM患者:化疗后组CD4+CD25+、CD4+CD25high、CD4+CD25+CD127low、CD4+CD25highCD127lowT细胞的比例均高于正常组,差异具有显著性;初诊组的CD4+CD25+CD127lowT细胞与正常对照组比较没有差异,但CD4+CD25+、CD4+CD25high、CD4+CD25highCD127lowT细胞与正常对照组比较差异具有显著性;初诊组CD4+CD25+T细胞的比例与化疗后组相比没有差异,但其CD4+CD25high、CD4+CD25+CD127low、CD4+CD25highCD127lowT细胞的比例均低于化疗后组,差异具有统计学意义。2)37例化疗后MM患者:稳定期与活动期的CD4+CD25+、CD4+CD25+CD127lowT细胞相比没有差异,但稳定期的CD4+CD25high、CD4+CD25highCD127lowT细胞明显低于活动期。结论CD4+CD25+Tregs在MM患者外周血中比例明显升高,且化疗可能影响其在外周血的比例;活动期MM患者CD4+CD25+Tregs的比例明显高于稳定期。这些提示CD4+CD25+Tregs可能是MM免疫抑制的一个重要原因。
Objective To investigate the changes and clinical significance of CD4 + CD25 + regulatory T cells (CD4 + CD25 + Tregs) in peripheral blood of patients with multiple myeloma (MM) at different stages of disease. To investigate the immunosuppressive mechanism of MM patients. Methods The proportions of CD4 + CD25 +, CD4 + CD25high, CD4 + CD25 + CD127low, CD4 + CD25highCD127lowT cells in 56 MM patients and 30 healthy volunteers were detected by flow cytometry and analyzed. Results 56 cases of MM patients: the proportion of CD4 + CD25 +, CD4 + CD25high, CD4 + CD25 + CD127low, CD4 + CD25highCD127lowT cells after chemotherapy was higher than the normal group, the difference was significant; the newly diagnosed group of CD4 + CD25 + CD127lowT There were no significant differences between the two groups in the number of CD4 + CD25 + T cells and CD4 + CD25high, CD4 + CD25highCD127lowT cells compared with the normal control group , But the proportion of CD4 + CD25high, CD4 + CD25 + CD127low, CD4 + CD25highCD127lowT cells were lower than the chemotherapy group, the difference was statistically significant. 2) There were no differences in 37 patients with MM after chemotherapy: stable CD4 + CD25high and CD4 + CD25highCD127low T cells in stable phase were significantly lower than those in active phase. Conclusion The proportion of CD4 + CD25 + Tregs in peripheral blood of patients with MM was significantly higher than that in patients with MM, and the proportion of CD4 + CD25 + Tregs in active MM patients was significantly higher than that in stable patients. These suggest that CD4 + CD25 + Tregs may be an important cause of MM immunosuppression.