沙利度胺联合GemOx方案治疗B-NHL患者的疗效及机制探讨  

Exploring the Curative Efficacy and Mechanism of Thalidomide Combined with GemOx Regimen in Treating B-NHL Patients

作　　者：李建安 陈慧华 杨兰平 文玲波 贾艳华 LI jianan(The Second Affiliated Hospital of Guangxi University of Science and Technology,Guangxi Liuzhou 545006,China)

机构地区：[1]广西科技大学第二附属医院肿瘤内科,广西柳州545006 [2]广西壮族自治区柳州市人民医院,广西柳州545026 [3]广西壮族自治区柳州市中医院肿瘤科,广西柳州545001

出　　处：《河北医学》2023年第3期496-500,共5页Hebei Medicine

基　　金：广西卫生与计划生育委员会自筹经费科研课题,(编号:Z2016720)。

摘　　要：目的:探究沙利度胺联合GemOx方案(奥沙利铂+吉西他滨)治疗复发难治性B细胞非霍奇金淋巴瘤(B-NHL)患者的疗效及机制。方法:40例复发难治性B-NHL患者,随机分为两组,治疗组20例采用沙利度胺联合GemOx方案治疗,对照组20例采用GemOx方案治疗。另选取同期20例健康体检者作为正常组。比较两个化疗组患者治疗后的临床疗效及不良反应情况,ELISA检测外周血TNF-α、IL-6水平,流式细胞术检测外周血Th17、NK细胞比率。结果:相较于对照组,治疗组总有效率高,血小板减少、白细胞减少、贫血、胃肠道反应、肝肾功能异常的发生率低(P<0.05)。相较于正常组,治疗组和对照组治疗前TNF-α、IL-6水平显著升高,Th17、NK细胞比率降低(P<0.05);相较于治疗前,治疗组和对照组治疗后TNF-α、IL-6水平均显著降低,Th17细胞比率升高(P<0.05),对照组NK细胞比率降低,治疗组NK细胞比率升高(P<0.05);相较于对照组,治疗组治疗后TNF-α、IL-6水平降低,Th17、NK细胞比率升高(P<0.05)。治疗组和对照组患者治疗前TNF-α、IL-6、Th17、NK细胞比率无差异(P>0.05)。结论:沙利度胺联合GemOx方案有望提高B-NHL患者的治疗有效率,降低血清TNF-α、IL-6水平,提高Th17、NK细胞比率。Objective:To explore the efficacy and mechanism of thalidomide combined with GemOx regimen(oxaliplatin+gemcitabine)in patients with relapsed and refractory B cell non-Hodgkin's lymphoma(B-NHL).Methods:Forty patients with relapsed refractory B-NHL were randomly divided into two groups.20 patients in the treatment group were treated with thalidomide plus GemOx regimen,and 20 patients in the control group were treated with GemOx regimen.In addition,20 healthy subjects in the same period were selected as the normal group.The levels of TNF-αand IL-6 in peripheral blood were detected by Elisa,and TH17 and NK cell ratio in peripheral blood were detected by Flow cytometry.Results:Compared with the control group,the total effective rate of the treatment group was higher,and the incidence of thrombocytopenia,leucopenia,anemia,gastrointestinal reaction,liver and kidney dysfunction was lower(P<0.05).The levels of TNF-α,IL-6,TH17 and NK cells were significantly higher in treatment group and control group than those in control group(P<0.05).Compared with before treatment,the levels of TNF-αand IL-6 in treatment group and control group were significantly lower,the ratio of Th17 cells was higher(P<0.05),the ratio of NK cells was lower in control group,and the ratio of NK cells was higher in treatment group(P<0.05).Compared with the control group,the levels of TNF-α,IL-6,Th17 and NK cells in the treatment group were lower than those in the control group(P<0.05).Before treatment,there was no difference in TNF-α,IL-6,Th17 and NK cell ratio between treatment group and control group(P>0.05).Conclusion:Thalidomide combined with GemOx regimen is expected to improve the efficacy of treatment in B-NHL patients,decrease serum levels of TNF-αand IL-6,and increase Th17 and NK cell ratio.

关 键 词：B细胞非霍奇金淋巴瘤 沙利度胺 炎症因子 免疫细胞 

分 类 号：R733.1[医药卫生—肿瘤]