中文摘要：

目的探讨异基因造血干细胞移植（allo-HSCT）后患者调节性T细胞、效应性T细胞以及两者之间的比例与疾病复发及慢性移植物抗宿主病（cGvHD）的关系。方法30例恶性血液病患者按复发与cGVHD的发生情况分成4组，分别为有复发有cGVHD组（4例）、有复发无cGVHD组（5例）、无复发有cGVHD组（14例）、无复发无cGVHD组（7例）。应用流式细胞术检测患者骨髓中CD4^＋CD25-CD69^＋调节T细胞和外周血中CD4^＋CD25^＋FoxP3^＋调节T细胞、Th1细胞和Th17细胞占CD4^＋T细胞比例，比较不同组间调节性T细胞、效应性T细胞以及两者比例。结果CD4^＋CD25^＋FoxP3^＋调节T细胞、CD4^＋CD25-CD69^＋调节T细胞、Th1细胞与Thl7细胞比例在不同组间差异均无统计学意义（P值均〉0．05）。9例复发患者的CD4^＋CD25-CD69^＋调节T细胞／Th1细胞比值为0．211±0．117，21例无复发者为0．133±0．160，差异有统计学意义（P=0．033），12例无cGVHD的患者中复发组亦高于无复发组（0．167±0．073对0．073±0．057，P=-0．048），有cGVHD同时伴有复发者高于无cGVHD无复发者（0．218±0．113对0．073±0．057，P=-0．024）。18例发生cGVHD的患者中CD4^＋CD25^＋FoxP3^＋调节T细胞／Th17细胞比值为1．975±2．045，12例无cGVHD者为3．198±1．132，差异有统计学意义（P=-0．010），21例无复发患者中有cGVHD者低于无cGVHD者（1．695±1．178对3．446±1．376，P=0．028）。结论CD4^＋CD25-CD69^＋调节T细胞／Th1细胞比值在复发时升高，CD4^＋CD25^＋FoxP3^＋调节T细胞／Th17细胞比值在cGVHD发生时降低，提示调节性T细胞与效应性T细胞的比例与复发及cGVHD相关。

英文摘要：

Objective To investigate the association of the ratio of regulatory and effector T cells with recurrence and chronic graft-versus-host disease （cGVHD） after allogeneic hematopoietic stem cell transplantation （allo-HSCT）. Methods Thirty patients with hematological malignancies who underwent allo-HSCT were classified as recurrence with cGVHD （n=4）, non-recurrence with cGVHD （n=14）, recurrence without cGVHD （n=5） and non-recurrence without cGVHD （n=7）. The different percentage of CD4＋CD25-CD69＋ regulatory T cells in bone marrow and CD4＋CD25＋FoxP3＋ regulatory T cells, Thl cells and Thl7 cells in peripheral blood were analyzed by flow cytometry. Results There were no significant differences in all these T-cell subsets among different groups （P 〉 0.05）. While the ratio of CD4＋CD25- CD69＋ regulatory T cells and Thl cells （0.211±0.177） in 9 recurrence patients was significant higher than that （0.133 ± 0.160） in 21 non- recurrence patients （P=-0.033）. The ratio were also significance between recurrence without cGVHD and non-recurrence without cGVHD patients （0.167±0.073 vs 0.073±0.057 ,P=- 0.048）, and between recurrence with cGVHD and non-recurrence without cGVHD patients （0.218±0.113 vs 0.073±0.057, P=-0.024）. Furthermore, the ratio of CD4＋CD25＋FoxP3＋ regulatory T cells and Thl7 cells was significant lower （1.975±2.045） in 18 cGVHD patients than that of 12 without cGVHD patients （3.198 ± 1.132, P=0.010）, and the ratio was also significant lower in non-recurrence patients with cGVHD （1.695±1.178） than that of without cGVHD （3.446±1.376,P=0.028）. Conclusion Our results show that the ratio of CD4＋CD25-CD69＋ regulatory T cells and Thl ceils raise in recurrence patients, and the ratio of CD4＋CD25＋FoxP3＋regulatory T ceils and Thl7 decrease in cGVHD patients, which suggest that the ratio of regulatory and effector T cells had association with recurrence and cGVHD in patients with allo-HSCT.