化疗联合参附注射液对急性白血病患者T淋巴细胞亚群、白介素-6、肿瘤坏死因子-α的影响

The influence of chemotherapy combined with Shenfu Injection on the T-lymphocyte subsets,IL-6,TNF-α of patients with acute leukemia

目的:探讨化疗联合参附注射液对急性白血病患者T淋巴细胞亚群、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的影响,进一步分析其治疗急性白血病的免疫机制。方法:将我院2008年1月～2010年1月收治住院治疗的30例急性白血病患者采用化疗联合参附注射液治疗,设为治疗组,另选同期30例急性白血病患者仅给予化疗治疗,设为对照组。应用流式细胞仪测定两组患者的T淋巴细胞亚群(CD4+T、CD8+T淋巴细胞百分比,并计算CD4+T/CD8+T比值)以及采用ELISA方法检测两组血清IL-6和TNF-α水平。结果:治疗组总有效率为76.7%,对照组总有效率为56.7%,两组总有效率比较差异有统计学意义(P<0.05)。治疗组和对照组治疗后的CD4+T、CD4+T/CD8+T[(31.30±6.25)%、(30.34±4.25)%、(1.08±0.16),(27.32±7.31)%、(29.25±6.18)%、(0.96±0.29)]均较治疗前[(25.43±7.14)%、(32.76±5.60)%、(0.81±0.25),(26.37±6.46)%、(31.52±4.74)%、(0.78±0.16)]明显升高,且治疗组上述指标较对照组变化更明显(P<0.05);两组CD8+T治疗前后变化不明显(P>0.05);对照组和治疗组的IL-6和TNF-α治疗后[(156.33±71.69)ng/L、(191.02±74.96)μg/L,(107.22±63.43)ng/L、(160.08±78.41)μg/L]均较治疗前[(295.98±84.69)ng/L、(1138.91±147.89)μg/L,(307.97±82.52)ng/L、(1122.13±145.64)μg/L]明显降低,且治疗组较对照组降低更明显(P<0.05)。结论:化疗联合参附注射液能明显改善急性白血病患者的免疫功能状态且两者对造血干细胞和白血病细胞增殖和分化具有一定的调控作用。

Objective： To investigate the influence of chemotherapy combined with Shenfu Injection on the T-lymphocyte subsets, interleukin-6 （IL-6）, tumor necrosis factor-α （TNF-α） of the patients with acute leukemia and the immune mech- anisms in treating acute leukemia in further analysis. Methods： 30 patients with acute leukemia treated with chemotherapy and Shenfu Injection in our hospital from January 2008 to January 2010 were taken as treatment group and 30 patients with acute leukemia in the same time given chemotherapy alone were taken as control group; the T-lymphocyte subsets （CD4＋T, CD8＋T-lymphocyte percentage and the ratio of CD4＋T/CD8＋T） of the two groups were determined by flow cytome- try, and the levels of serum IL-6 and TNF-α were detected by ELISA. Results： The total effective rate of the treatment group was 76.7%, the total effective rate of the control group was 56.7%, the difference was statistically significant be- tween two groups （P〈0.05）. After treatment, the level of CD4＋T, CD4＋T/CD8＋T of treatment group and control group [（31.30± 6.25）%, （30.34±4.25）%, （1.08±0.16）; （27.32±7.31）%, （29.25±6.18）%, （0.96±0.29）] were significantly higher than before treatment [（25.43±7.14）%, （32.76±5.60）%, （0.81±.25）; （26.37±6.46）%, （31.52＋4.74）%, （0.78±0.16）], the treatment group improved more significantly than the control group （P〈0.05）; after treatment, the level of IL-6 and TNF-α in control group and treatment group [（156.33±71.69） ng/L, （191.02＋74.96） μg/L; （107.22±63.43） ng/L, （160.08±78.41） μg/L] were sig- nificantly lower than before treatment [（295.98±84.69） ng/L, （1138.91 ±147.89） μg/L; （307.97±82.52） ng/L, （1122.13± 145.64） μ/L], the treatment group was decreased significandy than the control group （P〈0.05）. Conclusion： Chemotherapy combined Shenfu Injection can significantly improve immune function in patients with acute leukemia and they have some regulatory role for the proliferation and differentiation of hematopoietic stem cells and leukemia cells.