自体细胞因子诱导杀伤细胞治疗苯中毒的临床研究

Clinical experiment of cytokines induced killer cells for treatment of benzene poisoning

目的比较自体细胞因子诱导的杀伤细胞(cytokines induced killer,CIK)对不同程度苯中毒患者骨髓造血功能恢复的疗效及对免疫功能的影响。方法对轻度(10例)、中度(9例)和重度(13例)慢性苯中毒者采用CIK细胞治疗,另外选择轻度、中度苯中毒患者19例采用升白细胞药物治疗作为对照组。观察轻度、中度苯中毒患者治疗效果及治疗前后T淋巴细胞亚群的变化;统计重度苯中毒致再生障碍性贫血患者12例CIK细胞治疗效果(有效率、病死率),并观察其治疗前后T淋巴细胞亚群的变化、血细胞及骨髓恢复情况。结果轻度、中度苯中毒患者CIK细胞治疗后,白细胞和血小板恢复程度均明显高于对照组,差异有统计学意义(P<0.05),而且治疗时间较对照组明显缩短。32例CIK治疗组患者治疗前CD_4/CD_8的比值均倒置(<1),而治疗后在外周血细胞恢复正常时,CD_4/CD_8的比例也恢复正常。重度苯中毒患者采用CIK细胞治疗有效率高达91.7%(12/13),病死率为0%。结论CIK细胞治疗对苯中毒引起的骨髓造血功能障碍有明显疗效,且无毒副作用。该疗法为苯中毒治疗被开辟了新的途径。

Objective： To assess the reaction of cytokines induced killer （C1K） cells treatment in hematopoietic injury at different levels on patients with benzene poisoning and seek a novel, safe and effective immunotherapy for benzene poisoning. Methods CIK cells were in vitro activated by interleukin-2 （IL-2） and granulocyte-nmcrophage-colony-stimulating factor （GM-CSF） from the peripheral blood mononuclear cells （PBMC）. Thirty-two patients with benzene poisoning were treated with CIK cells. Nineteen patients with mild or moderate benzene poisoning in the control group were treated with VitB4, batilol, leucogen, inosine and stanozolol. The results for treatmen of 12 patients with aplastic anemia induced by severe benzene poisoning （the efficacy rate and the case fatality rate） were analyzed. The change of T-lymphocyte subset analyzed by flow cytometry was also observed before and after treatment. Results For mild or moderate benzene poisoning, the increase of WBC and RLT in CIK group was higher than that in the control group （P〈0.05）. The CD/CDs levels were significantly increased after CIK treatment. And for severe benzene poisoning, the effective rate of the CIK group was 91.7% and the mortality rate was 0%. Conclusion CIK treatment is safe and effective for hematopoietic injury caused by benzene poisoning. The mechanism may be related with the immune modulation of CIK treatment on immunodeficiency of patients with benzene poisoning.