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目的:检测多发性骨髓瘤(MM)患者外周血T辅助细胞亚群(Th1/Th2)及调节性T细胞(CD4+CD25+Tregs)数量和比例的变化,探讨其T细胞免疫功能状态及临床意义。方法:流式细胞术(FCM)检测31例MM患者及20例健康志愿者外周静脉血Th1/Th2及CD4+CD25+Tregs的比例并分析比较。结果:(1)II、III期MM患者Th1细胞比例较对照组降低,III期Th2细胞比例较对照组及I期降低,差异具有显著性;II、III期MM患者CD4+CD25+、CD4+CD25high、CD4+CD25highCD127low细胞比例均高于正常组,III期CD4+CD25high、CD4+CD25highCD127low较I期增高,差异具有显著性。(2)化疗后复发组MM患者Th1细胞比例较对照组降低,初诊组及化疗后复发组Th2细胞比例较对照组及稳定期组降低,差异具有显著性;初诊组及化疗后复发组CD4+CD25+、CD4+CD25high、CD4+CD25highCD127low细胞比例均高于正常组,复发组CD4+CD25+、CD4+CD25high、CD4+CD25highCD127low明显高于稳定组及初诊组,差异具有显著性。(3)相关性分析Th1、Th2细胞与CD4+CD25+Tregs存在不同程度的负相关(均P<0.05或0.01)。结论:MM患者外周血Th1、Th2细胞比例降低,调节性T细胞比例增高,两者相互调节,并与疾病临床分期、病情进展相关,对指导治疗也有一定的价值。
Objective: To detect the changes of the numbers and proportions of T helper subsets (Th1 / Th2) and regulatory T cells (CD4 + CD25 + Tregs) in peripheral blood of patients with multiple myeloma (MM) significance. Methods: The proportions of Th1 / Th2 and CD4 + CD25 + Tregs in peripheral venous blood of 31 MM patients and 20 healthy volunteers were detected by flow cytometry (FCM) and analyzed. Results: (1) The proportion of Th1 cells in stage II and III MM patients was lower than that in control group, and the proportion of stage III Th2 cells was lower than that in control group and stage I, the difference was significant. The levels of CD4 + CD25 +, CD4 + CD25high , CD4 + CD25highCD127low cells were higher than the normal group, phase III CD4 + CD25high, CD4 + CD25highCD127low higher than the phase I, the difference was significant. (2) The proportion of Th1 cells in MM patients relapsed after chemotherapy was lower than that in control group. The proportion of Th2 cells in newly diagnosed group and recurrent group after chemotherapy was lower than that in control group and stable group, with significant difference. The percentage of CD25 +, CD4 + CD25high and CD4 + CD25highCD127low cells were higher than that of the normal group. The recurrence group had significantly higher CD4 + CD25 +, CD4 + CD25high and CD4 + CD25highCD127low than the stable and newly diagnosed group. (3) Correlation analysis Th1, Th2 cells and CD4 + CD25 + Tregs have different degrees of negative correlation (all P <0.05 or 0.01). Conclusion: The proportion of Th1 and Th2 cells in peripheral blood of MM patients is decreased and the proportion of regulatory T cells is increased. The two are mutually regulated, and are related to the clinical stage and progression of the disease. They also have certain value in guiding the treatment.