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目的:探讨异基因造血干细胞移植(allo-HSCT)后NK细胞重建与急性移植物抗宿主病(aGVHD)发生及预后的相关性。方法:采用流式细胞术检测患者移植后30 d外周血中NK细胞的计数及活性,结合临床表现和相关病理指标综合评价患者aGVHD发病情况,分析NK细胞计数和活性与aGVHD发生及预后的相关性。结果:移植后发生aGVHD患者的NK细胞计数和活性与未发生aGVHD患者相比较显著降低,即655±216 cells/μl vs 1169±372 cells/μl(P=0.002)和7.3±3.6%vs 9.0±3.6%(P=0.008);发生Ⅱ-Ⅳ度aGVHD的患者与发生0-Ⅰ度aGVHD的患者相比,NK细胞计数和活性分别为617±220 cells/μl vs 1081±399 cells/μl(P=0.001)和4.2±1.7%vs 8.3±3.5%(P=0.001)。NK细胞计数和活性与aGVHD发病呈中度负相关。生存分析结果显示,Ⅱ-Ⅳ度aGVHD组复发率高(57%vs 5%)(P=0.010),1年无进展生存(PFS)率显著下降(43%vs 84%)(P=0.010)。结论:移植后NK细胞计数和活性与aGVHD的发生及预后存在一定相关性,提示通过监测NK细胞计数和活性可早期识别和预测aGVHD高危患者,也可能为aGVHD的防治提供了新思路。
Objective: To investigate the relationship between NK cell remodeling and the occurrence and prognosis of acute graft versus host disease (aGVHD) after allo-HSCT. Methods: The count and activity of NK cells in peripheral blood were detected by flow cytometry at 30 days after transplantation. The incidence of aGVHD in patients was evaluated by clinical manifestations and related pathological indexes. The correlation between NK cell count and activity and the occurrence and prognosis of aGVHD Sex. RESULTS: NK cell counts and activities in aGVHD patients after transplantation were significantly lower than those without aGVHD (655 ± 216 cells / μl vs 1169 ± 372 cells / μl vs 7.3 ± 3.6% vs 9.0 ± 3.6% (P = 0.008). The NK cell counts and activities were 617 ± 220 cells / μl vs 1081 ± 399 cells / μl in patients with grade Ⅱ-Ⅳ aGVHD and those with 0-Ⅰ degree aGVHD (P = 0.001) and 4.2 ± 1.7% vs 8.3 ± 3.5% (P = 0.001). There was a moderate negative correlation between NK cell count and activity and the incidence of aGVHD. The survival analysis showed that the recurrence rate was significantly lower in the a-IV aGVHD group (57% vs 5%) (P = 0.010) and 1-year progression-free survival (PFS) was significantly lower in the aGVHD group (43% vs 84% . CONCLUSION: NK cell count and activity after transplantation have some correlation with the occurrence and prognosis of aGVHD, suggesting that early detection and prediction of aGVHD high-risk patients by monitoring NK cell count and activity may provide new ideas for the prevention and treatment of aGVHD.