目的 了解骨髓增生异常综合征（myelodysplastic syndrome，MDS）患者骨髓γδ T细胞及其亚群的水平，探索MDS患者骨髓微环境的免疫缺陷状况。 方法 收集MDS患者治疗前后及正常供者骨髓样本，多色流式检测骨髓γδ T细胞及亚群水平，并分析MDS患者治疗后各细胞亚群的变化。 结果 MDS患者骨髓γδ T细胞和滤泡辅助性γδ T细胞明显降低（P < 0.05）。不同分化程度的γδ T细胞，仅初始γδ T细胞水平明显降低（P = 0.037），中枢记忆、效应记忆和终末分化γδ T细胞MDS患者与正常供者差异无统计学意义（P > 0.05）。免疫检查点PD1和TIM3阳性的γδ T细胞分别存在一定程度的降低和升高，但差异无统计学意义（P > 0.05）。治疗后获得疗效患者的γδ T细胞和初始γδ T细胞水平较治疗前明显升高，效应记忆γδ T细胞较治疗前明显降低（P < 0.05），85.71%（6/7）的MDS患者γδ + TIM3 + T细胞水平治疗后不同程度的降低。 结论 MDS患者骨髓微环境γδ T细胞及其亚群的水平存在不同程度的异常，治疗有效的患者，异常的γδ T细胞恢复，通过γδ T细胞及亚群水平检测可了解MDS的免疫缺陷状态，有可能作为判断疗效的指标，并为抗肿瘤免疫疗法提供新的资料。

Objective To investigate the levels of γδ T cells and their subpopulations in bone marrow（BM）of patients with myelodysplastic syndrome （MDS）， it aims to explore the immune deficiency status of BM microenvironment in MDS patients. Methods BM samples were collected from MDS patients before and after treatment， as well as from normal donors. Multicolor flow cytometry was utilized to detect bone marrow γδ T cells and subpopulation levels. The changes of the T cell subsets after treatment were also analyzed. Results The levels of BM γδ T cells and follicular helper γδ T cells from MDS patients were significantly lower than those of normal donors （P < 0.05）. Among γδ T cells at different stages of differentiation， only the frequencies of na?ve γδ T cells from MDS patients decreased significantly （P = 0.037）， and there was no significant difference observed about central memory， effector memory， and terminally differentiated γδ T cells in MDS patients compared to normal donors （P > 0.05）. Although there was a slight decrease in PD1+γδ T cells and an increase in TIM3+γδ T cells， these differences were not statistically significant （P > 0.05）. In patients who achieved a curative effect， the proportions of γδ T cells and naive γδ T cells increased significantly after treatment， and the effector memory γδ T cells decreased significantly after treatment （P < 0.05）. After treatment， 85.71% （6/7） of MDS patients showed a decrease in γδ+TIM3+ T cell levels to varying degrees. Conclusions The levels of γδ T cells and their subpopulations in the BM microenvironment of patients with MDS exhibit varying degrees of abnormalities. However， in patients who receive effective treatment， these abnormal γδ T cells can recover. By detecting the levels of γδ T cells and subpopulations， we can gain insights into the immune deficiency status of MDS. This information might serve as an indicator to assess treatment efficacy and provide valuable insights for anti?tumor immunotherapy.