目的 探讨单倍体异基因造血干细胞移植术后患儿慢性移植物抗宿主病（chronic graft versus host disease, cGVHD）的免疫学特征及预测因子，为早期干预提供依据。 方法 回顾性分析64例单倍体造血干细胞移植患儿的临床及实验室数据，检测外周血淋巴细胞亚群、免疫球蛋白及补体系统关键成分，通过单因素及多因素logistic回归分析筛选预测因子。 结果 cGVHD组（n=37）的辅助/诱导T淋巴细胞百分比、补体C3水平显著高于非cGVHD组（n=27），B细胞和自然杀伤细胞百分比显著低于非cGVHD组，差异均有统计学意义（P<0.05）。多因素logistic回归分析显示，辅助/诱导T淋巴细胞百分比（OR=1.144，P=0.012）与补体C3水平（OR=29.758，P=0.037）是cGVHD发生的独立预测因素。 结论 cGVHD的发生与T细胞稳态失衡、B细胞功能耗竭及补体系统异常激活密切相关。辅助性T淋巴细胞百分比和补体C3水平可作为cGVHD发生的潜在预测指标。

Objective To investigate the immunological characteristics and predictive factors of chronic graft-versus-host disease (cGVHD) in children after haploidentical allogeneic hematopoietic stem cell transplantation (Haplo-HSCT) to provide a basis for early intervention. Methods A retrospective analysis was conducted on clinical and laboratory data of 64 children undergoing Haplo-HSCT. Peripheral blood lymphocyte subsets, immunoglobulins, and key components of the complement system were measured. Univariable and multivariable logistic regression analyses were used to identify predictors. Results The percentage of helper/inducer T lymphocytes and complement C3 levels were significantly higher in the cGVHD group (n=37) compared to the non-cGVHD group (n=27) (P<0.05), while the percentages of B cells and natural killer (NK) cells were significantly lower (P<0.05). Multivariate logistic regression identified the percentage of helper/inducer T lymphocytes (OR=1.144, P=0.012) and complement C3 level (OR=29.758, P=0.037) as independent predictors of cGVHD. Conclusions The development of cGVHD is closely associated with T-cell homeostasis imbalance, B-cell functional exhaustion, and abnormal activation of the complement system. The percentage of helper/inducer T lymphocytes and complement C3 levels may serve as potential predictive indicators for cGVHD occurrence.