胸腺五肽联合化疗对多发性骨髓瘤患者外周血T淋巴细胞亚群的影响
[摘要]目的 探讨胸腺五肽联合化疗对多发性骨髓瘤患者外周血T淋巴细胞亚群的影响。方法 选择2016年7月～2017年7月在我院确诊的多发性骨髓瘤患者24例，采用随机数字表法将其分为单纯化疗组、化疗+胸腺五肽组，每组12例。单纯化疗组以TAD（沙利度胺+表柔比星+地塞米松）为主的方案化疗，连续应用4个疗程。化疗+胸腺五肽组以TAD为主的方案化疗同时加用胸腺五肽，连续应用4个疗程。两组患者治疗前及治疗结束血象基本恢復正常后应用流式细胞仪检测外周血淋巴细胞中总T细胞（CD3+）、辅助/诱导T细胞（CD4+）、抑制/细胞毒T细胞（CD8+）的比例、CD4+/CD8+比值。结果 化疗前两组患者细胞免疫功能的各项指标，差异无统计学意义（P>0.05），化疗+胸腺五肽组治疗后CD3+、CD4+阳性百分率及CD4+/CD8+比值均高于化疗前和单纯化疗组， 差异有统计学意义（P<0.05）；化疗+胸腺五肽组总有效率高于单纯化疗组，差异有统计学意义（P<0.05）。结论 胸腺五肽联合化疗能够改善多发性骨髓瘤患者的免疫功能，提高有效率，降低感染率。
[关键词]胸腺五肽；多发性骨髓瘤；淋巴细胞亚群；流式细胞仪
[中图分类号] R392.1 [文献标识码] A [文章编号] 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
多发性骨髓瘤（MM）是一种目前尚不能完全治愈的浆细胞恶性增殖性疾病，且其发病率呈逐年上升趋势，严重危害人类健康。化疗是MM 的主要治疗手段，但机体损伤大，病情多复发，国内外研究者发现[1-2]，MM 患者本身存在免疫系统的复杂缺陷。胸腺五肽是临床常用的免疫增强剂，能非特异性地刺激T淋巴细胞的增殖分化与成熟，调节T淋巴细胞亚群比例，调节与增强机体的免疫功能，因此，是肿瘤放、化疗过程中的重要辅助手段[3]。本研究选取应用胸腺五肽联合化疗治疗的12例多发性骨髓瘤患者作为研究对象，并与单纯化疗组进行对比，进行免疫功能机临床疗效的研究，现报道如下。