免疫细胞疗法对苯中毒所致骨髓造血功能障碍的改善作用

Effect of immunocyte therapy on benzene-induced bone marrow haemopoietic dysfunction

目的 探讨免疫细胞疗法对苯引起的骨髓造血功能损伤的疗效。方法 抽取患者外周血 4 0～ 5 0ml,分离单个核细胞经白细胞介素 2、粒细胞巨噬细胞集落刺激因子 (GM CSF)混合培养 6d ,收集形成的新免疫细胞并清除杂质后静脉回输给患者 ,治疗前后分别检测CD4 、CD8含量 ,重度苯中毒患者治疗前后均在右髂后上棘作骨髓穿刺涂片及骨髓病理检查。结果 2 0例慢性苯中毒患者中9例重度中毒者 ,经免疫细胞治疗后外周血细胞数、骨髓涂片及骨髓活检结果全部恢复正常 ;在治疗前T细胞亚群检测CD4 、CD8比例倒置者 ,经治疗后恢复正常比例 ,治疗期间分别定期检测心、肝、肾功能未发现异常。对所有治疗患者进行追踪观察 (最长为 1年 3个月 ) ,骨髓造血功能均在正常范围内。结论 苯中毒所致的骨髓造血功能障碍与免疫功能紊乱有密切关系 ,采用免疫细胞治疗对恢复苯中毒引起的骨髓造血功能障碍有显著疗效。

Objective To explore the effect of treatment with immunocyte therapy on benzene-induced haemopoietic dysfunction. Methods Mono-nuclear cells(MNC) were separated from 40～50 ml peripheral blood in patients and mixed with interleukin-2 and granulocyte macrophage colony stimulating factor(GM-CSF) for six day cultivation.The new formed immunocytes were collected and transfused into the patients.Bone marrow aspiration and biopsy were taken before and after therapy for all patients with severe benzene poisoning.Blood samples were stained by flow cytometry for detecting CD 4 and CD 8 positive cells. Results Of 20 patients with chronic benzene poisoning,9 were severe benzene poisoning.All examination including blood count,bone marrow biopsy and T cell subpopulation restored to normal after immunocyte therapy.Laboratory tests(liver and kidney function,and myocardial enzymes) were observed periodically and showed normal during therapy.Follow-up study(the longest time was more than 15 months)showed that bone marrow haemopietic function of all treated patients were in normal range. Conclusion Bone marrow haemopoietic dysfunction caused by benzene poisoning may be closely related to disorder of immune function.Immunocyte therapy may significantly improve bone marrow haemopoietic dysfunction induced by benzene poisoning.