论文部分内容阅读
目的探讨多发性骨髓瘤(MM)患者细胞免疫功能变化及其临床意义。方法采用流式细胞术检测天津医科大学总医院2008年1月至2009年12月住院诊疗的40例MM患者T细胞亚群、树突状细胞(DC)、效应性T细胞、辅助性T细胞(Th)及调节性T细胞数量变化,分析MM患者细胞免疫指标与血红蛋白(Hb)、β2微球蛋白(β2-MG)、白蛋白、血清肌酐及血清钙的相关性。结果与对照组相比,初诊组CD4+/CD8+、DC1/DC2、CD8+CD25+/CD3+T细胞的比值均降低;Th1/Th2比值显著降低(P<0.05);CD4+CD25+/CD3+T细胞的比值升高(P<0.01)。与初诊组相比,化疗后MM患者CD4+/CD8+、DC1/DC2及Th1/Th2比值显著升高(P<0.05)。CD8+CD25+/CD3+T的比值升高。与稳定期MM患者相比,进展期患者CD4+/CD8+、DC1/DC2、Th1/Th2及CD8+CD25+/CD3+T均降低,CD4+CD25+/CD3+T升高。CD4+/CD8+、DC1/DC2及Th1/Th2降低的MM患者,同时伴有β2-MG和肌酐升高(P<0.01),血红蛋白降低(P<0.01),白蛋白及血清钙降低。CD4+CD25+/CD3+T及CD4+CD25+CD127low/CD4+T升高的MM患者,伴有β2-MG和血清肌酐上升,血红蛋白和白蛋白降低。结论 MM患者T细胞亚群、DC、辅助性T细胞及效应性T细胞均有不同程度数量减少和功能下降,调节性T细胞相对数量增多,这些异常和MM病情及预后相关。
Objective To investigate the changes of cellular immune function in patients with multiple myeloma (MM) and its clinical significance. Methods Flow Cytometry was used to detect T cell subsets, dendritic cells (DCs), effector T cells and helper T cells in 40 MM patients hospitalized in Tianjin Medical University General Hospital from January 2008 to December 2009. (Th) as well as the number of regulatory T cells in MM patients. The correlation between cellular immune parameters and hemoglobin (Hb), β2 microglobulin (β2-MG), albumin, serum creatinine and serum calcium were analyzed. Results Compared with the control group, the ratios of CD4 + / CD8 +, DC1 / DC2 and CD8 + CD25 + / CD3 + T cells in the newly diagnosed group were decreased, while the Th1 / Th2 ratio was significantly decreased (P <0.01). Compared with the newly diagnosed group, the ratio of CD4 + / CD8 +, DC1 / DC2 and Th1 / Th2 in MM patients after chemotherapy was significantly increased (P <0.05). CD8 + CD25 + / CD3 + T ratio increased. Compared with stable MM patients, CD4 + / CD8 +, DC1 / DC2, Th1 / Th2 and CD8 + CD25 + / CD3 + T were decreased and CD4 + CD25 + / CD3 + T were increased in patients with advanced MM. CD4 + / CD8 +, DC1 / DC2 and Th1 / Th2 decreased in patients with MM accompanied by elevated β2-MG and creatinine (P <0.01), decreased hemoglobin (P <0.01) and albumin and serum calcium. MM patients with elevated CD4 + CD25 + / CD3 + T and CD4 + CD25 + CD127low / CD4 + T, with elevated β2-MG and serum creatinine, had decreased hemoglobin and albumin. Conclusion The number of T lymphocyte subsets, DCs, helper T cells and effector T cells in MM patients both decreased and decreased in quantity, and the relative numbers of regulatory T cells increased. These abnormalities were correlated with the prognosis of MM.