目的 探索CD4⁺细胞百分比（CD4⁺%）和NK细胞百分比（NK%）在预测儿童再生障碍性贫血（aplastic anemia, AA）疗效中的临床价值，为精准诊疗提供参考依据。 方法 回顾性研究2019年1月—2024年4月新疆医科大学第一附属医院接受环孢素A治疗的AA患儿临床资料。48例AA患儿为观察组，50例同期体检儿童为对照组。收集两组淋巴细胞亚群数据，分析组间差异及其与疗效的关系。依据血液学反应，将观察组分为有效组18例（HR组，含完全和部分缓解）及无效组30例（NHR组，含未缓解）。 结果 单因素分析显示，观察组的NK%显著低于对照组（P<0.05）。观察组随访3个月。HR组CD4⁺%低于NHR组（P=0.018），NK%高于NHR组（P=0.029）。多因素logistic回归分析显示，高CD4⁺%为疗效差的风险因素（OR=1.062），高NK%为保护因素（OR=0.820）。CD4⁺%与NK%联合预测AA患儿HR的曲线下面积为0.812。 结论 初诊时CD4⁺%水平升高是治疗效果不佳的预测因素，而NK%水平升高则与较好的预后相关。

Objective 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 (P<0.05). The observation group was followed up for 3 months. The HR group had a lower CD4⁺% than the NHR group (P=0.018) and a higher NK% than the NHR group (P=0.029). Multivariate logistic regression analysis indicated that a high CD4⁺% was a risk factor for poor treatment efficacy (OR=1.062), whereas a high NK% was a protective factor (OR=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.