【摘要】 目的分析肺癌并发恶性胸腔积液患者胸腔内注入顺铂联合香菇多糖前后胸水调节性T细胞(CD4C⁺D25C⁺D127^low)及CD4C⁺D25C⁺D127_high的改变,探讨香菇多糖联合顺铂胸腔内注射治疗肺癌并发恶性胸腔积液局部胸腔微环境的免疫功能改变。方法选取肺癌并发胸水患者60例（观察组和对照组各30例）。对照组给予顺铂50mg（体重>50kg）或40mg（体重<50kg）胸腔内注射治疗,观察组在对照组治疗的基础上加用香菇多糖（4mg）。两组患者分别于给药前及给药后第7、14天抽取胸水检测CD4C⁺D25C⁺D127^low及CD4C⁺D25C⁺D127_high。结果观察组总缓解率明显高于对照组（P<0.05）,不良反应发生率的差异无统计学意义（P>0 05）。给药前及给药后第7天,两组患者CD4C⁺D25C⁺D127^low/CD4及CD4C⁺D25C⁺D127_high/CD4的差异均无统计学意义（均P>0.05）;给药后第14天,观察组CD4C⁺D25C⁺D127^low/CD4明显低于对照组,CD4C⁺D25C⁺D127_high/CD4明显高于对照组,差异均有统计学意义（均P<0 05）。与给药前比较,给药后第7、14天CD4C⁺D25C⁺D127^low/CD4均明显降低,CD4C⁺D25C⁺D127_high/CD4均明显升高,差异均有统计学意义（P<0.05或0.01）。结论胸腔内注入顺铂联合香菇多糖能影响肺癌并发恶性胸腔积液患者胸水中调节性T细胞的水平,可能对胸腔内微环境的免疫功能改变有一定的优化作用。更多还原

【Abstract】 Objective To investigate the changes of regulatory T cells in pleural effusion in lung cancer patients with malignant pleural effusion undergoing cisplatin/lentinan treatment.Methods Sixty lung cancer patients with malignant pleural were assigned into two groups:patients in control group（n=30） received 40 mg or 50 mg cisplatin in pleural effusion,patients in study group（n=30） received 40 mg or 50 mg cisplatin plus 4mg lentinan.The levels of CD4⁺CD25⁺CD127^low and CD4⁺CD25⁺CD127^high in pleural effusion were detected before and d7,d14 after treatment.Results The remission rate（RR） in study group was significantly higher than that in control group（P<0.05）;and there was no significant difference in adverse reactions between two groups（P >0.05）.There were no differences in levels of CD4⁺CD25⁺CD127^low and CD4⁺CD25⁺CD127^high before and d 7 after treatment between two groups（P >0.05）;while the level of CD4⁺CD25⁺CD127^low in study group was lower and CD4⁺CD25⁺CD127^high was higher than those in control group at d14 after treatment（P<0.01 or 0.05）.Compared to those before treatment the level of CD4⁺CD25⁺CD127^lowwas reduced and CD4⁺CD25⁺CD127^highwas elevated at d7 and d14 after treatment（P<0.01 or 0.05）.Conclusion The levels of the regulatory T cells in pleural effusion are changed after cispatin combined with lentinan treatment,which may be associated with the improvement of local immune status of pleura.更多还原