肝硬化、肝癌患者免疫状态的临床研究

Clinical investigation on the immune state of patients with hepatic cirrhosis and primary hepatic carcinoma

目的研究肝硬化、肝癌患者免疫状态及相关对策。方法应用流式细胞仪,通过首测或复测法对17例肝硬化和8例肝癌患者的T细胞亚群、血球蛋白、NK细胞等指标行分组比较。结果与正常组比对,T细胞亚群和NK细胞的检测,发现CD4、CD4/CD8、NK细胞显著降低(P<0.05)。组间比较以肝硬化、肝性脑病、肝癌降低顺序排列(P<0.05),并伴有血球蛋白增高的反相变化。白介素Ⅱ对肝癌治疗可调整其细胞免疫的紊乱。结论肝硬化和肝癌免疫功能紊乱复杂,但有规律性。研究其规律性对这类肝病的进展、预后和指导治疗均有重要影响。

Objective To study the immune state and correlated strategy of patients with hepatic cirrhosis and primary hepatic carcinoma. Methods 17 patients with hepatic cirrhosis and 8 patients with primary hepatic carcinoma（PHC） in our hospital were collected since 2002. The indexes of immune function were detected in all patients and some were re-examined. Results It was found that although the immune index varied in patients suffering from severe liver diseases ,some regularities were shown as follows： （1）CD4 and CD4/CD8 in T lymphocyte subset declined markedly （P 〈 0.05 ） and CD8 was suppressed. （2）The number of T lymphocyte subset and NK cell decreased in cirrhotic patients,cirrhotic patients with hepatic encephalopathy and patients with PHC. The most significant descendent tendency was shown in patients with PHC compared with cirrhotic patients. （3）The number of T lymphocyte subset showed positive relation with that of NK cells and negative relation with humoral immune reaction（plasma globulin）. Conclusion The treatment of PHC with interleukin-2 has shown that the level of CD4 could be suitable index on drug efficiency and interleukin-2 therapy can adjust severe disorder of immune system.