Objective To investigate the expression of regulatory T cells(Treg)and T-cell subgroups in patients with aplastic anemia (AA ) and the relationship between Treg and T-cell subgroups and the severity and immunosuppressive effect of AA,and to provide a basis for selecting rational therapy of AA patients.Methods Cellular immune function of 46 AA patients with immunotherapy were analyzed by tricolour fluorescence labeled monoclonal antibody and multiparameter flow cytometry,including T-cell subtypes,CD4 + CD25 + Treg and effective T cells (Teff).The AA patients were divided into normal type of ratio,inverted type of ratio,hypernormal type of ratio according to the ratio of CD4 +/CD8 + cell in healthy control,and the AA patients were divided into normal type of ratio and low type of ratio according to the ratio of Treg/Teff cell in healthy control.Patients'condition and therapeutic effects were investigated between subtypes in patients with AA.Results ① The percentage of the normal type and the low type of CD127 low/CD127 high in all patients was respectively 28.3% (13/46 )and 71.1% (33/46 ).There was significant difference in percentage of Treg/Teff low type between SAA and NSAA,89.5%(1 7/1 9)vs 59.3%(1 6/27) (χ2 = 5.022, P 0.05 ). The rate of CD4 +/CD8 + immunological subtypes treating only with CSA between SAA and NSAA was respectively 46.2%(6/13),46.2%(6/13),7.7%(1/13)and 35.7%(5/14),28.6%(4/14),35.7%(5/14)(χ2 =2.983,P >0.05).③The positive rates of CD4 + CD25 + Treg cells and T cell subsets to monitor the abnormal immune status in patients with AA were 71.7% (33/46)and 60.9%(28/46),respectively.The CD4+ CD25 + Treg to monitor abnormal immune status was significantly sensitive than that of T cell subsets (χ2 =4.290,P 0.05)；单用环孢素治疗,有效和无效者按 CD4+/CD8+分3种亚型,分别占有效者46.2%(6/13)、46.2%(6/13)、7.7%(1/13),无效者为35.7%(5/14)、28.6%(4/14)、35.7%(5/14),差异无统计学意义(χ2=2.983,P >0.05)。③CD4+ CD25+ Treg和 T 细胞亚群监测 AA 患者免疫状态异常的阳性率分别为71.7%(33/46)和60.9%(28/46),CD4+ CD25+ Treg 监测免疫状态异常的敏感性高于 T 细胞亚群(χ2=4.290,P <0.05)。结论大多数患者存在 CD4+ CD25+ Treg 细胞和(或)T 细胞亚群的异常,与 AA 发病机制的免疫异常密切相关；在监测 AA 患者免疫功能异常、评估病情及免疫抑制剂疗效时,CD4+ CD25+ Treg 细胞比 T 细胞亚群更敏感；CD4+ CD25+ Treg 细胞联合 T 细胞亚群的监测对临床了解AA 病情和发病机制、合理用药、提高诊断和治疗水平有重要价值。
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