乙肝表面抗原阳性的非霍奇金淋巴瘤患者化疗前后 T 淋巴细胞亚群的变化

摘要

Objective It is to investigate the changes of T lymphocyte subsets and helper T lymphocytes ( Th ) drift in Hepatitis B surface antigen-positive ( HBsAg+) patients with non-Hodgkin’ s lymphoma ( NHL) before and after chemothera-py.Methods 82 patients with NHL were divided into positive group [26 cases, HBsAg(+)] and negative group [56 cases, HBsAg(-) ] according to whether HBsAg positive, the efficacy, and the levels of tumor necrosis factor ( TNF) -α, inter-leukin (IL) -10, IL-6, CD3 +, CD4 +, CD8 +, CD4 +/CD8 +, CD19 +, CD4 +CD25 +Treg and NK cell before and after treatment were observed and compared in each group.Results The complete remission rate of the positive group was signifi-cantly lower than that of the negative group (P<0.05).There was no significant difference in the levels of TNF-α, IL-10 , IL-6, CD3 +, CD4 +, CD8 +, CD4+/CD8 +, CD19 +, CD4 +CD25 +Treg and NK before treatment between the both groups (all P>0.05);after treatment, the levels of IL-10, IL-6, CD8 +, CD19 +and CD4 +CD25 +Treg after treatment were significantly lower and the levels of CD3 +, CD4+and CD4 +/CD8 +and NK were significantly higher in the both groups ( all P<0.05) , and there were significant differences between the both groups ( all P<0.05);the level of TNF-αof the positive group were significantly higher compared with before treatment and the negative group (all P<0.05).Conclusion The effect of chemotherapy in NHL patients with HBsAg(+) is significantly worse than that with HBsAg(-) , their mechanism may be associated with the disorders of cellular and humoral immune, and the abnormal drift of Th cells by HBV.%目的：探讨非霍奇金淋巴瘤（NHL）合并乙肝表面抗原（HBsAg）阳性患者化疗前后T淋巴细胞亚群和辅助性T淋巴细胞（ Th）的异常漂移变化，为该病的治疗提供更多依据。方法根据HBsAg是否阳性将82例NHL患者分为阳性组26例和阴性组56例，观察2组的疗效及治疗前后肿瘤坏死因子（ TNF）－α、白细胞介素（ IL）－10、IL－6、CD3＋、CD4＋、CD8＋、CD4＋／CD8＋、CD19＋、CD4＋CD25＋Treg和NK细胞水平的变化。结果阳性组的完全缓解率明显低于阴性组（P＜0．05）。2组治疗前TNF－α、IL－10、IL－6、CD3＋、CD4＋、CD8＋、CD4＋／CD8＋、CD19＋、CD4＋CD25＋Treg和NK细胞水平比较差异均无统计学意义（ P均＞0.05）；2组治疗后IL－10、IL－6、CD8＋、CD19＋、CD4＋CD25＋Treg均较治疗前明显降低（P均＜0.05），CD3＋、CD4＋、CD4＋／CD8＋、NK细胞水平均较治疗前明显升高（P均＜0．05），而阴性组变化较阳性组更为明显（P均＜0．05）；治疗后阳性组的TNF－α水平明显高于治疗前和阴性组（P均＜0．05）。结论 NHL合并HBsAg阳性患者化疗效果明显低于HBsAg阴性患者，其机制可能与HBV加剧机体的细胞和体液免疫紊乱及Th细胞的异常漂移有关。