[血清CD4和NK细胞对再生障碍性贫血患儿治疗反应的预后价值]
[Prognostic value of serum CD4 and NK cells for the treatment response in children with aplastic anemia].
作者信息
Wu Chun-Can, Yan Mei, Nuriddin Hailiguli, Ma Xu-Kai, Liu Yu
机构信息
Department of Pediatric Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2025 Jun 15;27(6):690-695. doi: 10.7499/j.issn.1008-8830.2410063.
OBJECTIVES
To evaluate the clinical value of CD4⁺ cell percentage (CD4⁺%) and NK cell percentage (NK%) in predicting treatment outcomes in children with aplastic anemia (AA), providing a reference for precise diagnosis and treatment.
METHODS
This retrospective study analyzed the clinical data of AA children treated with cyclosporine A at the First Affiliated Hospital of Xinjiang Medical University from January 2019 to April 2024. The study involved 48 AA children as the observation group and 50 children undergoing medical check-ups during the same period as the control group. Lymphocyte subset data were collected from both groups to analyze differences and their relationship with treatment efficacy. Based on hematological responses, the observation group was divided into an effective group of 18 patients (HR group, including complete and partial remission) and an ineffective group of 30 patients (NHR group, including non-remission).
RESULTS
Univariate analysis showed that NK% in the observation group was significantly lower than that in the control group (<0.05). The observation group was followed up for 3 months. The HR group had a lower CD4⁺% than the NHR group (=0.018) and a higher NK% than the NHR group (=0.029). Multivariate logistic regression analysis indicated that a high CD4⁺% was a risk factor for poor treatment efficacy (=1.062), whereas a high NK% was a protective factor (=0.820). The area under the curve for the prediction of HR in pediatric AA by combining CD4⁺% and NK% was 0.812.
CONCLUSIONS
A higher CD4⁺% at diagnosis is a predictor of poor treatment response, whereas a higher NK% is associated with better outcomes.
目的
评估CD4⁺细胞百分比（CD4⁺%）和自然杀伤细胞百分比（NK%）在预测再生障碍性贫血（AA）患儿治疗结局中的临床价值，为精准诊断和治疗提供参考。
方法
本回顾性研究分析了2019年1月至2024年4月在新疆医科大学第一附属医院接受环孢素A治疗的AA患儿的临床资料。研究纳入48例AA患儿作为观察组，同期50例接受体检的儿童作为对照组。收集两组的淋巴细胞亚群数据，分析差异及其与治疗疗效的关系。根据血液学反应，将观察组分为有效组18例（HR组，包括完全缓解和部分缓解）和无效组30例（NHR组，包括未缓解）。
结果
单因素分析显示，观察组的NK%显著低于对照组（<0.05）。对观察组进行3个月随访。HR组的CD4⁺%低于NHR组（=0.018），NK%高于NHR组（=0.029）。多因素logistic回归分析表明，高CD4⁺%是治疗疗效差的危险因素（=1.062），而高NK%是保护因素（=0.820）。联合CD4⁺%和NK%预测小儿AA中HR的曲线下面积为0.812。
结论
诊断时较高的CD4⁺%是治疗反应差的预测指标，而较高的NK%与较好的结局相关。
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