ABSTRACT:Objective To study the changes in serum copper and zinc levels and copper/zinc ra-tio in aplastic anemia,and to investigate their effect on T lymphocyte subsets.Methods Atomic absorption spectrophotometry was used to detect serum copper and zinc levels and copper/zinc ra-tio and flow cytometry was used to measure T lymphocyte subsets in peripheral blood in 50 aplas-tic anemia patients (initial treatment group)and 40 healthy subjects (control group).According to different treatments,42 patients who receive follow-up were divided into two groups:standard treatment group (androgen+ immunosuppressants,n = 22)and zinc gluconate treatment group (androgen+ immunosuppressants + zinc gluconate,n = 20 ).Results Compared with control group,serum copper levels and copper/zinc ratio increased and serum zinc levels decreased in ini-tial treatment group (P < 0.01 ).The copper/zinc ratio was negatively correlated with CD4 +/CD8+ (r=-0.45,P =0.005).Compared standard treatment group,zinc gluconate treatment pro-moted the recovery of CD4+/CD8+ ratio (P =0.000).Conclusion Both copper/zinc ratio and T lymphocyte subset imbalance are involved in the onset and prognosis of aplastic anemia.%目的：研究血清铜、锌及铜／锌比值在再生障碍性贫血中的水平变化，以及对外周血 T 淋巴细胞亚群的影响。方法选择50例再生障碍性贫血患者（初治再障组），经过正规治疗，可随访患者42例[根据治疗方法不同分为标准治疗组（22例，应用雄激素＋免疫抑制剂治疗）和葡萄糖酸锌治疗组（20例，在标准治疗组基础上加用萄糖酸锌口服液治疗）]。选择同期40例健康正常人为正常对照组。采用原子吸收分光光度法测定血清铜、锌及铜／锌比值，流式细胞仪检测患者外周血 T 淋巴细胞亚群。结果初治再障组患者血清铜含量及铜／锌比值均高于正常对照组，而锌含量明显低于正常对照组（均 P ＜0．01）。再生障碍性贫血患者铜／锌比值与 CD4＋／CD8＋呈负相关（r＝"0．45，P ＝0．005）。治疗后葡萄糖酸锌治疗组患者 CD4＋／CD8＋比值恢复好于标准治疗组（P ＝0．000）。结论铜／锌比值与 T 淋巴细胞亚群失调共同参与再生障碍性贫血的发病及转归。
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