合并乙肝病毒感染对弥漫大B细胞淋巴瘤患者细胞免疫功能的影响

Effect of Hepatitis B Virus Infection on Cellular Immune Function of Patients of Diffuse Large B-Cell Lymphoma

目的探讨合并乙肝病毒(Hepatitis B Virus,HBV)感染对弥漫大B细胞淋巴瘤(Diffuse Large B Cell Lymphoma,DLBCL)患者细胞免疫功能的影响。方法均接受联合免疫化疗治疗的DLBCL患者296例,采用四色流式分析法测定患者化疗前、化疗3个月、化疗6个月、化疗12个月时其外周血CD3+、CD4+、CD8+、CD4+/CD8+水平,分析HBs Ag阳性、HBs Ag阴性患者相关免疫指标的变化情况。结果在化疗后3个月,阳性组患者CD3+水平较化疗前和阴性组均出现显著下降,差异具有统计学意义(P<0.05);在化疗后6个月、12个月时,两组患者CD3+水平并无明显差异(P>0.05);在化疗期间,阳性组患者CD4+水平并无明显变化,但其CD4+/CD8+水平呈持续下降趋势,化疗后3个月、6个月、12个月时均显著低于阴性组,差异具有统计学意义(P<0.05)。结论合并HBV感染易造成DLBCL患者在化疗过程中出现细胞免疫功能下降。

Objective To explore the effect of hepatitis B virus（ HBV） infection on cellular immune function in patients with diffuse large B cell lymphoma（ DLBCL）. Methods 296 patients with DLBCL treated with combined immunotherapy were firstly chosen as the subjects of study. The levels of CD3＋,CD4＋,CD8＋ and CD4＋/CD8＋ in peripheral blood of the subjects before chemotherapy,3 months,6 months and 12 months after chemotherapy were measured by four-color flow analysis. The changes of the immune parameters related to HBs Ag positive and HBs Ag negative patients were analyzed.Results At 3 months after chemotherapy,the levels of CD3 ＋ in the positive group were lower than those in the negative group and before chemotherapy（ P〈0.05）. No statistically significant difference was found in CD3＋ level between 6 months and 12 months after chemotherapy（ P〉0.05）. There was no significant change in CD4＋ level in the positive group,but the CD4＋/CD8＋ level continued to decrease after 3 months,6 months and 12 months after chemotherapy. At 3 months,6 months and 12 months after chemotherapy,the levels of CD4 ＋/CD8 ＋ in the positive group were lower than those in the negative group（ P〈0.05）. Conclusions HBV infection can lead to the decline of cellular immune function in patients with DLBCL during chemotherapy.