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目的观察急性淋巴细胞性白血病（ＡＬＬ）完全缓解期免疫功能对微小残留病（ＭＲＤ）及预后的影响。方法检测ＩｇＨ和ＴＣＲｓ基因重排以反映ＭＲＤ，以外周血Ｔ细胞亚群、ＮＫ细胞、ＩＬ－２、ＩＬ－６、ｓＩＬ－２Ｒ、ＴＮＦ－α、ＩＦＮ－α等指标反映免疫功能，系统观察２５例ＡＬＬ患者完全缓解期免疫功能与ＭＲＤ的变化。结果刚获完全缓解时，ＣＤ＋４细胞、ＮＫ细胞、ＩＬ－２减少，ＴＮＦ－α，ｓＩＬ－２Ｒ、ＣＤ＋８细胞增多，其后，上述异常有所恢复，ＭＲＤ转阴者的恢复程度优于ＭＲＤ未转阴者，ＭＲＤ快速转阴者的恢复程度又优于缓慢转阴者。结论患者免疫功能、ＭＲＤ转归及预后之间密切相关。
Objective To observe the effect of immune function on the minimal residual disease (MRD) and prognosis of acute lymphoblastic leukemia (ALL) in complete remission period. Methods The IgH and TCRs gene rearrangements were measured to reflect the MRD. Peripheral blood T cell subsets, NK cells, IL-2, IL-6, sIL-2R, TNF-α, IFN-α and other indicators reflected immune function. Immune function and MRD changes in complete remission stage in 25 ALL patients. Results After complete remission, CD+4 cells, NK cells, and IL-2 decreased, and TNF-α, sIL-2R, and CD+8 cells increased. Subsequently, the above abnormalities were restored, and the degree of recovery of MRD was better than that of MRD. For those who turned negative, the degree of recovery of MRD quickly turned better than that of slow turning. Conclusion The patient’s immune function, MRD outcome, and prognosis are closely related.