摘要
目的:探讨骨肉瘤患者围手术期间细胞免疫功能的动态变化及其临床意义。方法:膝关节周围Ⅱb期初治骨肉瘤患者37例,应用流式细胞仪检测其术前化疗前、术前化疗后,及术后第1、7、14天外周血T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)及NK细胞水平的变化。以膝关节周围骨折患者33例作为对照。结果:肿瘤组术前化疗前后T淋巴细胞亚群及NK细胞改变不明显(1.63<t<1.95,0.20>P>0.05);术前2次CD4+、CD4+/CD8+、NK细胞及术后3次CD3+、CD4+、CD4+/CD8+、NK细胞检查结果均不同程度低于骨折组,差异有统计学意义(2.10<t<3.35,0.001<P<0.05)。两组患者术后第1天免疫抑制最明显,以后逐渐恢复,肿瘤组免疫抑制较骨折组严重,而且恢复速度较慢。结论:骨肉瘤患者的细胞免疫功能存在较明显的缺陷,术后出现免疫抑制,且恢复能力和速度均低于骨折组。
Objective： To investigate the kinetic changes and clinical significance of cell immunofuction in perioperative patients with osteosarcoma. Methods： T lymphocyte subsets （CD3＋, CD4＋, CDS＋, CD4＋/CD8＋） and NK cells were examined in 37 patients with primary IIb osteosarcomas around knee joints before and after preoperative chemotherapy, and on the postoperative 1st, 7th, 14th day with flow cytometry, and in 33 patients with juxta-articular fractures of knee joints as control. Results： There were no significant difference between the two preoperative experimental results （T lymphocyte subsets and NK cell） in tumor group （1.63〈t〈1.95, 0.20〉P〉0.05）. Both two preoperative results（CD4＋,CD4＋/CD8＋,NK cells） and three postoperative resuhs（CD3＋,CD4＋,CD4＋/CD8＋,NK cells） were significantly lower than those of fracture group, and there were statistical differences （2.10〈t〈3.35, 0.001〈P〈0.05）. Immunosupression on the postoperative 1st day was severer than that of any other time in each group and from then on immunofunction had been recovering gradually. Immunofunction of tumor group was worse than that of fracture group and the patients in the former recovered more slowly than those of the latter. Conclusion： There are obvious abnormalities of the cell immunofunction in patients with osteosarcoma, and their ability and speed of recovering immunofunction from postoperative immunosupression are significantly lower than fracture patients＇.
出处
《山东大学学报（医学版）》
CAS
北大核心
2006年第2期173-177,共5页
Journal of Shandong University:Health Sciences
关键词
骨肉瘤
T淋巴细胞
杀伤细胞
天然
手术期间
免疫
细胞
Osteosarcoma
T lymphoeytes
Killer cells, natural
Intraoperative period
Immunity,cellular
