本文關(guān)鍵詞： 利妥昔單抗(美羅華) DLBCL 免疫球蛋白 T淋巴細(xì)胞亞群　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:檢測(cè)彌漫大B細(xì)胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)患者兩種不同化療方案前后外周血中免疫球蛋白、T淋巴細(xì)胞亞群、β2微球蛋白及CD4+CD25+調(diào)節(jié)性T細(xì)胞(CD4+CD25+regulatory T cells,Treg)的變化,探討R-CHOP與CHOP方案對(duì)DLBCL患者免疫系統(tǒng)的影響。方法:選取2014年9月~2017年1月在本院接受R-CHOP方案治療的初治DLBCL患者48例為試驗(yàn)組,另選取同期接受CHOP方案化療的初治DLBCL患者44例為對(duì)照組。于初診時(shí),每療程化療后采集患者空腹血檢測(cè)外周血中免疫球蛋白、T淋巴細(xì)胞亞群、β2微球蛋白及Treg的水平。結(jié)果:(1)治療前,試驗(yàn)組與對(duì)照組免疫球蛋白IgA、IgG、IgM含量相當(dāng),均低于正常水平。試驗(yàn)組在治療后免疫球蛋白IgA、IgG、IgM水平均逐漸降低,3個(gè)療程后IgM水平低于治療前(P0.05),4個(gè)療程后IgA、IgG、IgM均低于治療前(P0.05)。對(duì)照組治療過(guò)程中IgA、IgG、IgM水平略有降低趨勢(shì),但無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。治療5個(gè)療程后,試驗(yàn)組IgA、IgG、IgM與對(duì)照組相比差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)治療前,試驗(yàn)組與對(duì)照組CD3、CD4、CD8、CD4/CD8無(wú)差異,CD3、CD4、CD4/CD8均低于正常水平,CD8高于正常水平。試驗(yàn)組在實(shí)施R-CHOP方案治療后CD3、CD4、CD4/CD8水平逐漸降低,CD8水平逐漸升高,第1個(gè)療程以后CD3、CD8水平與治療前比較有統(tǒng)計(jì)學(xué)差異(P0.05),而CD4、CD4/CD8從第2個(gè)療程后才開(kāi)始與治療前比較差異有顯著性(P0.05)。對(duì)照組在治療過(guò)程中各T淋巴細(xì)胞亞群水平均未發(fā)生明顯變化。試驗(yàn)組CD3、CD4、CD8、CD4/CD8在治療2個(gè)療程后與對(duì)照組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)試驗(yàn)組與對(duì)照組患者治療前β2-MG均明顯高于正常水平,1療程治療后檢測(cè)結(jié)果明顯下降,與治療前比較有統(tǒng)計(jì)學(xué)差異(P0.05)。試驗(yàn)組與對(duì)照組治療后β2-MG水平都降低,兩組相比無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。(4)試驗(yàn)組與對(duì)照組化療前外周血Treg高于正常水平,化療后外周血Treg水平降低,4療程治療后檢測(cè)結(jié)果明顯下降,與治療前相比有統(tǒng)計(jì)學(xué)差異(P0.05)。試驗(yàn)組與對(duì)照組治療后Treg水平都降低,兩組比較無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:DLBCL患者初診時(shí)免疫功能即受到明顯抑制,R-CHOP方案化療后,患者免疫球蛋白明顯下降,T淋巴細(xì)胞亞群紊亂,機(jī)體的免疫功能受損。
[Abstract]:Objective: to detect the diffuse large B cell lymphoma (diffuse large B cell lymphoma, DLBCL) before and after two different chemotherapy regimens in patients with immunoglobulin in peripheral blood protein, T lymphocyte subsets, beta 2 microglobulin and CD4+CD25+ regulatory T cells (CD4+CD25+regulatory T cells, Treg) changes, to explore the effects of R-CHOP and CHOP on the immune system in patients with DLBCL. Methods: September 2014 ~2017 year in January in our hospital R-CHOP in the treatment of newly diagnosed DLBCL patients 48 cases as experimental group and the other selected received CHOP chemotherapy for newly diagnosed DLBCL patients 44 cases as control group. In the initial period of chemotherapy, each fasting blood of patients with immune detection the ball in the peripheral blood protein, T lymphocyte subsets, beta 2 microglobulin and Treg. Results: (1) before treatment, the experimental group and the control group of immunoglobulin IgA, IgG, IgM levels were lower than the normal level, in the test group. 鍚庡厤鐤悆铔嬬櫧IgA,IgG,IgM姘村鉤鍧囬，

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