CAJ | 학술논문

目的：分析老年非小细胞肺癌患者化疗前后细胞免疫功能变化。方法62例非小细胞肺癌患者根据年龄分为老年组（≥60岁）和青年组（＜60岁），分别在化疗前及化疗后第2周检测淋巴细胞及其亚群CD3、CD4、CD8水平，与20例健康志愿者（对照组）进行比较。结果治疗前老年组和青年组CD3[（51．87±2．56）％，（58．98±3．87）％]、CD4[（35．01±5．12）％，（42．12±3．54）％]、CD4／CD8[（0．89±0．49）％，（1．08±0．86）％]水平均明显低于对照组CD3（69．38±8．54）％、CD4（48．21±3．45）％、CD4／CD8（1．87±0.85）％（t＝10．586、5.998、10．087、6．093、5．170、3．236，均 P＜0．05），老年组和青年组 CD8[（32．68± 3.64）％、（30．24±2．45）％]水平均高于对照组[（26．10±2．89）％]水平（t＝6．777、5．531，均P＜0.05）；老年组患者的CD3与CD4、CD4／CD8水平均明显低于青年组患者（t＝8．472、6．394、3．059，均P＜0.05），老年组CD8水平高于青年组患者（t＝3．114，P＜0．05）；化疗2个周期后老年组与青年组患者的CD3明显低于治疗前水平（t＝10．233、16．847，均P＜0．05），但两组患者的CD4、CD8、CD4／CD8水平治疗前后差异无统计学意义（P＞0．05）；两组患者化疗后CD3水平比较差异无统计学意义（P＞0．05），老年组患者化疗后CD4水平低于青年组患者（t＝7．130，P＜0.05），两组化疗后CD8、CD4／CD8水平比较差异无统计学意义（P＞0．05）；Ⅰ～Ⅱ期患者的CD3水平明显高于Ⅲ～Ⅳ患者（t＝1．584、1．721，均P＜0．05），两组患者的CD4、CD8、CD4／CD8比较差异无统计学意义（P＞0.05）。结论对于老年非小细胞肺癌患者需要辅助针对性的免疫治疗，同时需要根据患者的年龄和临床分期调整患者化疗药物剂量。
목적：분석노년비소세포폐암환자화료전후세포면역공능변화。방법62례비소세포폐암환자근거년령분위노년조（≥60세）화청년조（＜60세），분별재화료전급화료후제2주검측림파세포급기아군CD3、CD4、CD8수평，여20례건강지원자（대조조）진행비교。결과치료전노년조화청년조CD3[（51．87±2．56）％，（58．98±3．87）％]、CD4[（35．01±5．12）％，（42．12±3．54）％]、CD4／CD8[（0．89±0．49）％，（1．08±0．86）％]수평균명현저우대조조CD3（69．38±8．54）％、CD4（48．21±3．45）％、CD4／CD8（1．87±0.85）％（t＝10．586、5.998、10．087、6．093、5．170、3．236，균 P＜0．05），노년조화청년조 CD8[（32．68± 3.64）％、（30．24±2．45）％]수평균고우대조조[（26．10±2．89）％]수평（t＝6．777、5．531，균P＜0.05）；노년조환자적CD3여CD4、CD4／CD8수평균명현저우청년조환자（t＝8．472、6．394、3．059，균P＜0.05），노년조CD8수평고우청년조환자（t＝3．114，P＜0．05）；화료2개주기후노년조여청년조환자적CD3명현저우치료전수평（t＝10．233、16．847，균P＜0．05），단량조환자적CD4、CD8、CD4／CD8수평치료전후차이무통계학의의（P＞0．05）；량조환자화료후CD3수평비교차이무통계학의의（P＞0．05），노년조환자화료후CD4수평저우청년조환자（t＝7．130，P＜0.05），량조화료후CD8、CD4／CD8수평비교차이무통계학의의（P＞0．05）；Ⅰ～Ⅱ기환자적CD3수평명현고우Ⅲ～Ⅳ환자（t＝1．584、1．721，균P＜0．05），량조환자적CD4、CD8、CD4／CD8비교차이무통계학의의（P＞0.05）。결론대우노년비소세포폐암환자수요보조침대성적면역치료，동시수요근거환자적년령화림상분기조정환자화료약물제량。
Objective To study of cellular immune function change of elderly patients with non-small car-cinoma after chemotherapy.Methods 62 patients with non-small carcinoma by age was divided into elderly group (≥60 years old)and youth group (<60 years old).The lymphocytes and their subsets CD3,CD4,CD8 levels were detected respectively in 2 weeks after chemotherapy and chemotherapy before compared with 20 cases of healthy vol-unteers.Results The immune condition of CD3[(51.87 ±2.56)%,(58.98 ±3.87)%]and CD4[(35.01 ± 5.12)%,(42.12 ±3.54)%],CD4/CD8[(0.89 ±0.49)%,(1.08 ±0.86)%]levels were significantly lower than those of healthy controls.Two groups of patients compared with healthy group CD3(69.38 ±8.54)%,CD4(48.21 ± 3.45)%,CD4/CD8(1.87 ±0.85)%(t=10.586,5.998,10.087,6.093,5.170,3.236,all P<0.05),and CD8 [(32.68 ±3.64)%,(30.24 ±2.45)%]levels were higher than those of healthy controls (26.10 ±2.89%)(t=6.777,5.531,all P<0.05);The CD3 and CD4,CD4/CD8 of elderly group patients were markedly lower than that of young patients (t=8.472,6.394,3.059,all P<0.05).The CD8 levels of the elderly group was higher than young patients (t=3.114 2,P<0.05);The Elderly group and young patients after 2 cycles of chemotherapy CD3 signifi-cantly was lower than before treatment (t=10.233,16.847,all P<0.05),but the two groups of patients with CD4, CD8 and CD4/CD8 levels before and after treatment (P>0.05);There was no significant difference with CD3 level of the two groups of patients after chemotherapy (P>0.05);The CD3 level of the two groups of patients after chemo-therapy was no significant difference (P>0.05),the elderly group patients after chemotherapy with CD4 levels was lower than young patients (t=7.130,P<0.05).The CD8 and CD4/CD8 level of the two groups after chemotherapy were no significant difference (P>0.05);The CD3 levels of patient withⅠ-Ⅱ stage were significantly better than patients withⅢ-Ⅳstage (t=1.584,1.721,all P<0.05),the CD4,CD8 and CD4/CD8 level of the two groups had no significant difference(P>0.05).Conclusion The senile non-small carcinoma patients need assistance targeted immunotherapy,also need to adjust according to the patient's age and clinical staging in patients with chemotherapy drug doses.