中文摘要：

【摘要】目的探讨非清髓性自体外周血造血干细胞移植（NAST）治疗sLE后的免疫重建规律。方法总结10例接受NAST的SLE患者移植后的随访情况。动员方案为异环磷酰胺（IFO）＋粒细胞集落刺激因子（G—CSF）。非清髓性预处理方案：移植前1～2d，阿糖胞苻（200mg·kg-1·d-1）加环磷酰胺（40mg·kg-1·d-1）。应用流式细胞学技术分别于动员前、动员后，移植后2周及1、2、3、6、12、24、36、48及60个月监测患者体内的T细胞（CD3＋）、B细胞（CDl9＋）、NK细胞（CD3一CDl6’CD56＋）、Th细胞（CD3CD4＋）、Tc细胞（CD3＋CD8＋）、调节性T细胞（CD4＋CD25＋）和CD4／CD8＋比值的变化。采用t检验进行统计学分析。结果CD3＋细胞动员前为（1232＋354）／ram3，12个月后恢复正常。CD4＋细胞动员前为（602224）／mm3，移植后48个月恢复正常。CD8＋细胞动员前为（404215）／m，n3，移植后2个月恢复正常。CDl6＋CD56＋细胞动员前为（115＋38）／ram3，移植后36个月恢复正常。CDl9＋细胞动员前为（43±11）／ram3，移植后6个月恢复正常。CD4＋CD25＋细胞动员前为（6．9±1．4）／mm3，移植后24个门趋于稳定。CD8＋T细胞恢复早于CD4＋T细胞，CD4＋／CD8＋持续降低，移植7个月后逐渐回升。B细胞在移植后10个月恢复至正常。NK细胞移植后24个月恢复至正常并保持稳定。调节性T细胞与CD4＋细胞比值（CD4‘CD257CD4＋）移植后逐渐增加。结论NAST可以使难治性SLE患者病情明显缓解，监测移植后外用淋巴细胞、T细胞亚群、B细胞、NK细胞、调节性T细胞可评定疾病预后并可能早期预判复发。SLE患者行NAST后是否复发尚需进一步随访。

英文摘要：

Objective To investigate the immunological reconstitution after non-myeloablative autologous peripheral blood stem cell transplantation （NAST） in patients with systemic lupus erythematosus （SLE）. Methods Summarized the outcomes of l0 patients with SLE after NAST. These patients received non-myeloablative conditioning regimen： mobilization with ifosfamide （IF（）） and colony-stimulating factor, pre-treatment regimen was composed of eytarabine （Ara-c. 200 mg kg-1 d-1 ） alnt cyelophosphamide （CTX, 40 mg＇kg-t＇d-）. Flow cytomet analysis was used to monitor the level of T lymphocytes（CD3＋）, B lymphoeytes （CDI9＋ ）, NK cells （CD3-CD16＋CD56＋ ）, T helper cells （CD3 ＋CD4＋ ）, T suppressor cells （CD3 ＋CD8＋ ）, regulatory T cells （CD4CD25） and the ratio of CD4qCD8＋ cells before and aider mobilization and 1/2, 1, 2, 3, 6, 12, 24, 36, 48, 60months after transplantation. T test was used for statistical analysis. Results The count of CD3＋ cell befi）re mobilization was （ 1 232＋354）/mm, which returned to normal after 12 months. The count of CD4＋ cell before mobilization was （602＋224）/mm, returned to normal after 48 months. The count of CD8＋ cells before mobilization was （404＋215）/mm3, which returned to normal after 2 months. The count of CDI6＋CD56 cells beh）re mobilization was （115＋38）/mm3, which returned to normal after 36 months. The count of CDI9＋ cells before mobilization was （43_＋11 ）/mm, which returned to normal at 6 months. The countof CD19 cells before mobilization was （43＋11）/ram3, which returned to normal after 6 months. The count of CD4＋ CD25 cellsbefore mobilization was （6.9-＋1.4）/mm3, which returned to normal and remained stable after 24 months. Thetime of CD8＋ T cells recovery in the T subtypes was shorter than that of the CD4＋ subtypes. The ratio of CD4/CD8＋ continued to decline, gradually raised only until 7 months after transplantation. The level of B lymphocytes returned to normal unt