CAJ | 학술논문

目的：观察神经母细胞瘤（neuroblastoma，NB）患儿化疗前后免疫功能指标的变化，并探讨其临床意义，为进行NB 化疗的免疫调节和支持治疗提供依据。方法选择我院自2007年1月至2009年2月收治的NB患儿，分别检测血清中免疫球蛋白（IgG、IgA、IgM、IgE）和血液中细胞免疫，包括总T淋巴细胞（TTL，CD3＋，CD19-），T辅助淋巴细胞（THL，CD3＋，CD4＋），T抑制淋巴细胞（TSL，CD3＋，CD8＋）、NK细胞（CD3-，CD16＋/CD56＋）百分比及辅助/抑制 T细胞（CD4＋/CD8＋）比率。结果患儿化疗前体液免疫水平基本正常，细胞免疫功能低于正常。化疗后体液免疫IgG、IgA、IgM、IgE均较化疗前降低。细胞免疫中，TTL、CD4＋/CD8＋较化疗前下降，而THL、TSL、NK细胞较化疗前升高。有统计学差异（P＜0.05）。结论联合化疗会造成NB患儿体液及细胞免疫功能紊乱，监测T细胞亚群水平及Ig系列对评估患者细胞及体液免疫功能，以及应用免疫调节和支持治疗，以减少化疗后感染机会，提高生活质量有积极的意义。
목적：관찰신경모세포류（neuroblastoma，NB）환인화료전후면역공능지표적변화，병탐토기림상의의，위진행NB 화료적면역조절화지지치료제공의거。방법선택아원자2007년1월지2009년2월수치적NB환인，분별검측혈청중면역구단백（IgG、IgA、IgM、IgE）화혈액중세포면역，포괄총T림파세포（TTL，CD3＋，CD19-），T보조림파세포（THL，CD3＋，CD4＋），T억제림파세포（TSL，CD3＋，CD8＋）、NK세포（CD3-，CD16＋/CD56＋）백분비급보조/억제 T세포（CD4＋/CD8＋）비솔。결과환인화료전체액면역수평기본정상，세포면역공능저우정상。화료후체액면역IgG、IgA、IgM、IgE균교화료전강저。세포면역중，TTL、CD4＋/CD8＋교화료전하강，이THL、TSL、NK세포교화료전승고。유통계학차이（P＜0.05）。결론연합화료회조성NB환인체액급세포면역공능문란，감측T세포아군수평급Ig계렬대평고환자세포급체액면역공능，이급응용면역조절화지지치료，이감소화료후감염궤회，제고생활질량유적겁적의의。
Objective To observe immune function in children with neuroblastoma (NB)before and after chemotherapy,to explore its clinical significance and provide the basis for immunomodulatory and supportive therapy in the NB chemotherapy.Methods This study enrolled children with NB treated in our hospital from January 2007 to February 2009 .We detected the percentage of immunoglobulin (IgG,IgA,and IgM,IgE)in serum and cellular immunity including total T lymphocytes (TTL,CD3 +and CD19 -),T helper lymphocytes (THL,CD3 +and CD4 +),T suppressor lymphocytes (TSL,CD3 +and CD8 +),NK cells (CD3 -,CD16 +/CD56 +),and the ratio of CD4 +and CD8 +(CD4 +/CD8 +). Results The level of humoral immunity was normal and the cellular immune function was lower than normal before chemotherapy.But the humoral immunity was decreased after chemotherapy.TTL and CD4 +/CD8 +were decreased,and the THL,TSL,as well as NK cells were increased after chemotherapy with significant differences (P<0.05).Conclusions Combined chemotherapy can cause humoral and cellular immune dysfunction in children with NB.It is necessary to monitor T cell subsets and Ig series for assessment of cellular and humoral immune function for application of immune regulation and supportive treatment,which is helpful to reduce infection during chemotherapy and improvement the quality of life in patients with NB.