白细胞介素-2联合小柴胡汤治疗对自体造血干细胞移植后患者免疫功能的影响

Immune function effect of interleukin-2 combined with minor bupleurum decoction on autologous haemopoietic stem cell transplantation

目的探讨白细胞介素2(IL-2)联合小柴胡汤治疗对自体造血干细胞移植(AHSCT)后患者免疫功能的影响。方法51例急性白血病AHSCT后患者分为观察组和对照组,观察组于造血功能恢复后应用IL-2联合小柴胡汤治疗18个月,对照组移植后不再进行任何治疗。分别于移植前及造血功能恢复后18个月内每月检测比较观察组与对照组患者CD4+、CD8+细胞和Th1、Th2,并观察比较2组的3 a、5 a、7 a无病生存率及复发率。结果对照组移植后1～18个月CD4+、Th1值均低于移植前(P<0.05);观察组的CD4+、Th1值移植后1～2个月低于移植前(P<0.05),3个月开始恢复正常;从第3个月开始观察组的CD4+、Th1值均高于对照组(P<0.05)。观察组与对照组CD8+值仅在移植后2个月内均低于移植前(P<0.05),2组间无差异(P>0.05)。对照组的Th2移植后第2个月开始明显高于移植前水平(P<0.05),且高于观察组同时段值(P<0.05)。观察组5 a和7 a无病生存率均显著高于对照组(P<0.05),3 a、5 a和7 a复发率显著低于对照组(P<0.05)。结论IL-2联合小柴胡汤治疗能使ASHCT后患者免疫功能早期得以恢复,无病生存时间延长,复发率明显降低。

Objective To study the immune function effect of interleukin-2 combined with minor bupleurum decoction on autologous haemopoietic stem cell transplantation（AHSCT）.Methods 51 cases after AHSCT were divided into observation group and control group.The cases in observation group were treated with interleukin-2（IL-2） and minor bupleurum decoction for 18 months after haematopoietic function recovery.The lymphocytes of CD4^＋,CD8^＋ and Th1/Th2 were detected pretransplant and after haematopoietic function recovery every month within 18 months,and compared the index between two groups.The disease free survival（DFS） rate of 3-,5-or 7-year and the relapse rate were compared between two groups.Results The number of CD4^＋ and Th1 cells postgraft were lower than pretransplant from 1^th to 18^th month（P〈0.05）.The number of CD4^＋ and Th1 cells postgraft in observation group lower than pretransplant in the first two months（P〈0.05）,and recovered in the 3rd month,and the number of CD4^＋ and Th1 cells in observation group were higher than that in control group from the 3^rd month（P〈0.05）.The number of CD8^＋ cells postgraft was lower than pretransplant only in the first two months（P〈0.05）,and there was no difference between two groups（P〉0.05）.The number of Th2 postgraft in control group was higher than pretransplant significantly from the 2^nd month（P〈0.05）,and also higher than that in observation group at the same time（P〈0.05）.The disease free survival（DFS） rate of 5-year and 7-year in observation group were significantly higher than that in control group（P〈0.05）.The relapse rate of 3-year,5-year and 7-year in observation group were significantly lower than that in control group（P〈0.05）.Conclusion The immune function of the patients who are treated with interleukin-2 and minor bupleurum decoction after AHSCT can recover earlier.And it can prolong the disease-free survival time and reduce the relapse rate.