非霍奇金淋巴瘤免疫功能的变化及临床意义

摘要

目的：探讨非霍奇金淋巴瘤（ NHL ）免疫功能的变化及其临床意义。方法初治NHL患者50例为实验组，采集静脉血检测T细胞亚群、NK细胞及免疫球蛋白（ Ig）水平，与30名健康对照者进行比较；并对50例患者中不同临床分期、有无B症状及治疗有效无效组进行比较。结果实验组外周血CD4＋、 NK细胞计数及CD4＋／CD8＋比值均明显低于对照组（P＜0．05），实验组与对照组的CD3＋、CD8＋、CD19＋计数比较差异无统计学意义（ P＞0．05）；实验组中，治疗无效组、有B组症状组、Ⅲ＋Ⅳ期组的CD4＋、NK细胞计数及CD4＋／CD8＋比值明显降低（P＜0．05）；实验组与对照组及实验组各亚组间的IgA、IgG 、IgM水平比较，差异均无统计学意义（P＞0．05）。结论 NHL患者存在细胞免疫抑制，其临床分期、治疗疗效与细胞免疫功能有关，而与体液免疫的相关性有待进一步探讨。%Objective To investigate the changes of immune function in patients with non-Hodgkin′s lymphoma ( NHL) and its clinical significance .Methods Fifty newly diagnosed NHL patients ( experimental group ) were enrolled in this study and 30 healthy adults served as control .Their venous blood samples were collected to detect the levels of T lymphocyte subsets ,NK cells and immunoglobulin ( Ig ) .The comparative analysis was conducted among patients with different clinical stages ,with B symptoms or not ,and with different curative effects .Results The levels of CD4+,NK cells,CD4+/CD8+of experimental group were significantly lower than those of control group (P<0.05),while there was no significant difference in the levels of CD3+,CD8+and CD19+between experimental group and control group (P>0.05).In the experimental group ,the levels of CD4+,NK cells ,CD4+/CD8+decreased significantly in the uncured patients ,patients with B symptoms,and patients of stageⅢorⅣ(P<0.05).There were no significant differences in the levels of IgA ,IgG and IgM between experimental group and control group as well as among subgroups of experimental group ( P>0 .05 ) . Conclusion The cellular immune response is suppressed in patients with NHL,and the suppression is correlated with clinical stage,B symptoms and curative effect of NHL.But the correlation with humoral immune needs to be further explored .