复发性生殖器疱疹细胞免疫与治疗的相关性研究

摘要

目的 检测复发性生殖器疱疹患者治疗前、后外周血T淋巴细胞亚群,观察治疗效果,并探讨机体细胞免疫的相关作用机理.方法 复发性生殖器疱疹患者口服泛昔洛韦250mg,每天3次,连服5天,同时给予胸腺五肽1 mg肌注,每天1次,15次为一疗程,共4个疗程.采用流式细胞仪检测52例复发性生殖器疱疹患者治疗前、后T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+),并与40例健康对照组进行比较.结果治疗组与健康对照组相比外周血CD3+、CD4+及CD4+/CD8+下降,CD8+升高,两组间差异有统计学意义(P＜0.01).经抗病毒药物与免疫调节剂联合治疗2个月后,外周血CD3+、CD4+及CD4+/CD8+回升,而CD8+下降,治疗前、后差异有统计学意义(P＜0.01).治疗前每例年平均发作4.5次,治疗后每例年平均发作1.5次,治疗前、后差异有统计学意义(P＜0.05).结论 复发性生殖器疱疹患者存在细胞免疫功能紊乱,抗病毒药物与免疫调节剂联合应用能改善患者的细胞免疫功能紊乱状况,降低生殖器疱疹复发率.%Objective To observe the therapy efficacy in patients with recurrent genital herpes (RGH)via the detection of the change in peripheral blood T-lymphocyte subpopulation,and to explore the related mechanisms of cell-mediated immunity.Methods 52 patients received a 4-course thempy with oral famciclovir of 250mg,thrice daily for 5 days and an injection of thymopentin of 1 mg once daily for 15days.T-lymphocyte subpopulation(CD3+.CD4+.CD8+,and CD4+/CD8+)was detected by flow cytometry before and after treament.The results were then compared those from the healthy controls.Results As compared with those the control group,CD3+.CD4+.and CD46/CD8+were decreased and CD8+was increased in the treatment group,with a statistical difference between the two groups(P＜0.01 ). After a 2-month therapy with antiviral drugs and immunomodulators,CD3+.CD4+ and CD4+/CD8+ elevated and CDs+declined.There was a statistical difference after treatment(P＜0.01). Before treatment,each patient had flare-up 4.5 times annually on average,but only 1.5 times after treatment,with a statistical difference(P ＜0.05). Conclusions Cellular immune dysfunction may occur in patients with RGH.Therapy with antiviral drugs and immunomodulators can improve cell-mediated immunity in the patients,and reduce the recurrence of genital herpes.