预存式自体输血联合同种异体自然杀伤细胞输注对胃癌手术后患者免疫功能的影响

The Effect of Predeposited Autologous Blood Transfusion Combined with Allogeneic NK Cell Infusion on the Immune Function of Postoperative Patients With Gastric Cancer

目的探讨预存式自体输血联合同种异体自然杀伤细胞(natural killer cell,NK)输注对胃癌手术后患者免疫功能的影响。方法按照随机数字表法将120例胃癌患者分为对照组和观察组,各60例。对照组采用异体输血;观察组采用预存式自体输血联合同种异体NK细胞输注。两组均以治疗10d为1个疗程;治疗前后采用单向免疫扩散法测定补体C3、C4水平,速率散射比浊法测定血清免疫球蛋白IgG、IgA和IgM,酶联免疫吸附试验检测治疗前后白细胞介素-10(interleukin,IL-10)、白细胞介素-2(interleukin-2,IL-2)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平,采用流式细胞仪法测定T细胞亚群(CD4^+、CD3^+、CD8^+及CD4^+/CD8^+)。结果两组治疗后C3、C4、IL-2和IL-10水平升高,血清IgG、IgA、IgM和TNF-α水平均下降。观察组CD3^+、CD4^+、CD8^+及CD4^+/CD8^+细胞异常例数均少于对照组;IgG、IgA、IgM、C3及C4异常例数少于对照组,差异有统计学意义(P<0.05)。CD8、TNF-α水平低于对照组;C3、C4、IL-2、IL-10、CD3+、CD4+、CD4+/CD8+水平高于对照组,差异有统计学意义(P<0.05)。结论预存式自体输血联合同种异体自然杀伤细胞输注能促进T细胞亚群平衡,调节肿瘤手术患者体液免疫,有利于提高患者免疫力,调节炎性细胞因子水平。

Objective To investigate the effect of predeposited autologous blood transfusion combined with allogeneic natural killer(NK)cell infusion on the immune function of postoperative patients with gastric cancer.Methods 120 patients were divided randomly into the observation group and control group according to the random number table,and each group included 60 cases.The control group was treated with allogeneic blood transfusion,while the observation group was treated with predeposited autologous blood transfusion combined with allogeneic NK cell infusion.The treatment course lasted for 10 days in both groups.The levels of C3 and C4 were detected by the single immunodiffusion method,those of IgG,IgA and IgM were assayed by rate nephelometry,those of interleukin-10(IL-10),interleukin-2(IL-2)and tumor necrosis factor-α(TNF-α)were detected by enzyme-linked immunosorbent assay(ELISA)and those of T-cell subsets(CD4+,CD3+,CD8+,and CD4+/CD8+)were detected by flow cytometry both before and after treatment.Results The levels of C3,C4,IL-2 and IL-10 were increased and those of IgG,IgA,IgM and TNF-αwere decreased after treatment in both groups.The abnormal cell numbers of CD3+,CD4+,CD8+and CD4+/CD8+in the observation group were less than those in the control group and those of IgG,IgA,IgM,C3 and C4 were less in the observation group than in the control group,and the differences were statistically significant(P<0.05).The levels of CD8 and TNF-αwere lower in the observation group than in the control group and those of C3,C4,IL-2,IL-10,CD3+,CD4+and CD4+/CD8+in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Predeposited autologous blood transfusion combined with allogeneic NK cell infusion can promote the balance of T cell subsets,regulate the humoral immunity which is beneficial to improve the immunity,and reduce the levels of inflammatory cytokines in postoperative patients with gastric cancer.