胸腺五肽聯(lián)合化療對多發(fā)性骨髓瘤患者外周血T淋巴細(xì)胞亞群的影響

　　[摘要]目的 探討胸腺五肽聯(lián)合化療對多發(fā)性骨髓瘤患者外周血T淋巴細(xì)胞亞群的影響。方法 選擇2016年7月～2017年7月在我院確診的多發(fā)性骨髓瘤患者24例，采用隨機數(shù)字表法將其分為單純化療組、化療+胸腺五肽組，每組12例。單純化療組以TAD（沙利度胺+表柔比星+地塞米松）為主的方案化療，連續(xù)應(yīng)用4個療程�；�療+胸腺五肽組以TAD為主的方案化療同時加用胸腺五肽，連續(xù)應(yīng)用4個療程。兩組患者治療前及治療結(jié)束血象基本恢復(fù)正常后應(yīng)用流式細(xì)胞儀檢測外周血淋巴細(xì)胞中總T細(xì)胞（CD3+）、輔助/誘導(dǎo)T細(xì)胞（CD4+）、抑制/細(xì)胞毒T細(xì)胞（CD8+）的比例、CD4+/CD8+比值。結(jié)果 化療前兩組患者細(xì)胞免疫功能的各項指標(biāo)，差異無統(tǒng)計學(xué)意義（P>0.05），化療+胸腺五肽組治療后CD3+、CD4+陽性百分率及CD4+/CD8+比值均高于化療前和單純化療組， 差異有統(tǒng)計學(xué)意義（P<0.05）；化療+胸腺五肽組總有效率高于單純化療組，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 胸腺五肽聯(lián)合化療能夠改善多發(fā)性骨髓瘤患者的免疫功能，提高有效率，降低感染率。
　　[關(guān)鍵詞]胸腺五肽；多發(fā)性骨髓瘤；淋巴細(xì)胞亞群；流式細(xì)胞儀
　　[中圖分類號] R392.1 [文獻(xiàn)標(biāo)識碼] A [文章編號] 1674-4721（2018）2（b）-0074-03
　　Effect of thymopentin combined with chemotherapy on T lymphocyte subsets in peripheral blood of patients with multiple myeloma
　　HU Ting PENG Li-ping ZHANG Chen-xiao
　　Department of Hematology，People′s Hospital of Pingxiang City in Jiangxi Province，Pingxiang 337000，China
　　[Abstract]Objective To investigate the effect of thymopentin combined with chemotherapy on T lymphocyte subsets in peripheral blood of patients with multiple myeloma.Methods 24 patients with multiple myeloma diagnosed in our hospital from July 2016 to July 2017 were selected and randomly divided into chemotherapy group chemotherapy + thymopentin group，12 cases in each group.In the chemotherapy group，tad （thalidomide+epirubicin + dexamethasone） was used as the main chemotherapy regimen for 4 consecutive courses.In the chemotherapy plus thymopentin group，TAD was the main chemotherapy regimen and thymopentin was added for 4 consecutive courses.Total T cells （CD3+），helper / inducible t cells （CD4+），inhibition/cytotoxic T cells （CD8+） ratio and CD4+/CD8+ ratio in peripheral blood lymphocytes were measured by flow cytometry before and after treatment.Results There was no significant difference in cellular immune function between the two groups before chemotherapy （P>0.05）.CD3+，CD4+ positive percentage and CD4+/CD8+ ratio of chemotherapy + thymopentin group were higher than those before chemotherapy and chemotherapy alone （P<0.05）.The total effective rate of chemotherapy + thymopentin group was higher than that of chemotherapy group （P<0.05）.Conclusions Thymopentin combined with chemotherapy can improve the immune function of patients with multiple myeloma， improve the effective rate， reduce the infection rate.
　　[Key words]Thymopentin；Multiple myeloma；Lymphocyte subpopulation；Flow cytometry
　　多發(fā)性骨髓瘤（MM）是一種目前尚不能完全治愈的漿細(xì)胞惡性增殖性疾病，且其發(fā)病率呈逐年上升趨勢，嚴(yán)重危害人類健康�；�療是MM 的主要治療手段，但機體損傷大，病情多復(fù)發(fā)，國內(nèi)外研究者發(fā)現(xiàn)[1-2]，MM 患者本身存在免疫系統(tǒng)的復(fù)雜缺陷。胸腺五肽是臨床常用的免疫增強劑，能非特異性地刺激T淋巴細(xì)胞的增殖分化與成熟，調(diào)節(jié)T淋巴細(xì)胞亞群比例，調(diào)節(jié)與增強機體的免疫功能，因此，是腫瘤放、化療過程中的重要輔助手段[3]。本研究選取應(yīng)用胸腺五肽聯(lián)合化療治療的12例多發(fā)性骨髓瘤患者作為研究對象，并與單純化療組進(jìn)行對比，進(jìn)行免疫功能機臨床療效的研究，現(xiàn)報道如下。

相關(guān)熱詞搜索：胸腺 淋巴細(xì)胞 化療 患者 影響