脾氨肽辅助治疗对小儿喉乳头状瘤T淋巴细胞亚群变化及疗效的影响

Changes of T-lymphocyte subsets in peripheral blood of children with juvenile-onset laryngeal papilloma and the adjuvant effect of spleen aminopeptide

目的探讨小儿喉乳头状瘤(JLP)患儿外周血T淋巴细胞(简称T细胞)亚群的变化及脾氨肽对JLP患儿T细胞亚群的影响和疗效。方法 60例JLP病例随机分为JLP联合治疗组(30例)和JLP手术组(30例),所有JLP患者均采用喉内镜下电动吸割器切除新生物,联合治疗组术后同时口服脾氨肽辅助治疗,手术组不加任何免疫治疗。以同期体检的20例健康儿童做对照组,对JLP病例组(未治疗前)、健康对照组、JLP联合治疗组和JLP手术组进行外周血T细胞亚群的检测,并对脾氨肽辅助治疗JLP的疗效进行分析。结果治疗前JLP病例组CD3+T细胞、CD4+T细胞百分率及CD4+/CD8+T细胞比值较健康对照组降低,差异有统计学意义(P<0.05);治疗后JLP联合治疗组CD3+T细胞、CD4+T细胞百分率明显升高(P<0.05),CD4+/CD8+T细胞比值恢复平衡;治疗后JLP联合治疗组较JLP手术组的疗效明显提高(P<0.05)。结论 JLP患儿存在T细胞介导的免疫功能障碍,脾氨肽可恢复JLP患儿T细胞亚群的正常比例,改善患儿的细胞免疫功能,对JLP有较好的辅助治疗作用。

Objective To investigate the Changes of T-lymphocyte subsets in peripheral blood of children with juvenile onset laryngeal papilloma （JLP）and the adjuvant effect of spleen aminopeptide. Methods Sixty children with JLP were randomly divided into group A and group B, with thirty patients in each group. All of the JLP had been removed with electric suction cutter under laryngeal endoscope.The children in group A were treated with operation combined with spleen aminopeptide taken orally while the others in group B accepted operative treatment only. Twenty healthy children who had physical examination during the same period were enrolled as the control group.Flow cytometric analysis was employed to study T-lymphocyte subsets in Peripheral Blood of 60 children with JLP and 20 healthy controls. Results Before treatment, the percentage of CD3＋T, CD4＋T lymphocyte subsets and the ratio of CD4＋ /CD8＋of the JLP children were all significantly lower than those of the healthy control group （P〈0.05）. The percentage of CD3＋T, CD4＋T lymphocyte subsets and the clinical efficacy in JLP children after treatment with spleen aminopeptide were all significantly increased （P〈0.05）, while the ratio of CD4＋ /CD8＋T returned to normal. Conclusions The T-lymphocyte subsetsmediated cellular immune function is depressed in children with JLP. Treatment with spleen aminopeptide can recover the imbalance of the ratio of T-lymphocyte subsets and improve the cellular immune function in JLP children, and has a good adjuvant effect for JLP.