恶性胸腔积液患者T淋巴细胞亚群的检测及临床意义

Study on measurement of T-lymphocyte subsets in patients with malignant pleural effusions

目的 观察恶性胸腔积液患者胸腔内注射顺铂 (DDP)前、后T淋巴细胞亚群的变化。方法 30例确诊的恶性胸腔积液患者 ,尽量排尽胸腔积液后 ,胸腔内注入生理盐水 2 0ml +顺铂 4 0mg ,每周给药 1次 ,连用 1～ 3次 ,治疗前及其后 1个月分别查血T淋巴细胞亚群 ,并与正常对照组比较。结果 恶性胸腔积液患者治疗前、后CD+ 3 、CD+ 4 、及CD+ 4 /CD+ 8明显低于正常 (P<0 0 5～ 0 0 1 ) ,CD+ 8明显升高 (P <0 0 1 ) ,而治疗后 ,除CD+ 8降低显著外 (P <0 0 5 ) ,其余指标与治疗前比较差异无显著性 (P>0 0 5 )。结论 T淋巴细胞亚群测定对恶性胸腔积液的诊断。

AIM To study changes of peripheral blood T lymphocyte subsets in patients with malignant pleural effusions (MPE) before and after intralumen injections with DDP. METHODS 30 cases of patients with MPE were treated with NS 20 ml+DDP 40 mg once a week for 1～3 weeks after the effusions were drained, T lymphocyte subsets were determined in them before therapy and one month later separately ,then compared them with those in the controlled group. RESULT CD + 3,CD + 4 and CD + 4/CD + 8 ratio before and after the treatment in MPE group were significantly lower than those in the controlled group ( P <0 05～0 01), while CD + 8 greatly higher ( P <0 01) than those in the controlled group, and compared between before and after therapy, only CD + 8 dropped statistically ( P <0 05). CONCLUSIONS The immunity was suppressed in the patients with MPE. Measurement of T lymphocyte subsets might be useful in the diagnosis, treatment and prognosis assessment of MPE .