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目的:探讨胸腺肽联合化疗对晚期胃肠道肿瘤患者细胞免疫功能的影响。方法:将80例晚期胃肠道肿瘤患者随机分为化疗组和胸腺肽联合化疗组,化疗组采用常规化疗治疗,胸腺肽联合化疗组在化疗基础上加用胸腺肽。25例体检者作为健康对照组。分别于治疗前及2周化疗期结束后10天检测外周血T淋巴细胞亚群及Thl型细胞因子(IL-2)、Th2型细胞因子(IL-10)。结果:与健康对照组相比,晚期胃肠道肿瘤患者治疗前T淋巴细胞亚群(CD3+,CD4+和CD4+/CD8+比值)及IL-2明显下降,CD8+及IL-10升高(P<0.05)。治疗后两组患者CD3+,CD4+,CD4+/CD8+比值明显升高(P<0.05),胸腺肽联合化疗组变化更显著,与化疗组有显著差异(P<0.05)。胸腺肽联合化疗组患者IL-2下降(P<0.05),IL-10升高(P<0.05),化疗组IL-2,IL-10与化疗前相比没有统计学意义。胸腺肽联合化疗组有效率高于化疗组(P<0.05)。结论:晚期胃肠道肿瘤患者T淋巴细胞免疫功能低下,Th2类细胞因子呈优势表达。胸腺肽联合化疗可杀灭肿瘤细胞,减轻肿瘤负荷,改善患者的细胞免疫功能。
Objective: To investigate the effect of thymosin combined with chemotherapy on cellular immune function in patients with advanced gastrointestinal cancer. Methods: Eighty patients with advanced gastrointestinal cancer were randomly divided into chemotherapy group and thymosin combined chemotherapy group. The chemotherapy group was treated with conventional chemotherapy. Thymosin combined with chemotherapy group was given thymosin on the basis of chemotherapy. Twenty-five patients were selected as healthy control group. Peripheral blood T lymphocyte subsets, Thl type cytokines (IL-2) and Th2 type cytokines (IL-10) were detected before treatment and 10 days after the 2-week chemotherapy. Results: Compared with healthy control group, T lymphocyte subsets (CD3 +, CD4 + and CD4 + / CD8 + ratio), IL-2 and CD8 + and IL-10 in patients with advanced gastrointestinal cancer were significantly increased ). After treatment, the ratio of CD3 +, CD4 + and CD4 + / CD8 + was significantly increased in both groups (P <0.05). Thymosin combined with chemotherapy group changed more significantly than that in chemotherapy group (P <0.05). The levels of IL-2 in thymosin combined with chemotherapy group decreased (P <0.05) and IL-10 increased (P <0.05). The levels of IL-2 and IL-10 in chemotherapy group were not significantly different from those before chemotherapy. The effective rate of thymosin combined with chemotherapy group was higher than that of chemotherapy group (P <0.05). Conclusion: T lymphocytes in patients with advanced gastrointestinal cancer have low immune function and predominantly Th2 cytokines. Thymosin combined with chemotherapy can kill tumor cells, reduce tumor burden and improve cellular immune function.