T细胞亚群与应用免疫检查点抑制剂的肿瘤患者产生不良反应的相关性分析  

Correlation analysis of T cell subsets and adverse effects in tumor patients with immune checkpoint inhibitors

作　　者：王皓[1] 高宏[2] 邢向荣[2] WANG Hao;GAO Hong;XING Xiang-rong(Liaoning University of Traditional Chinese Medicine,Shenyang 110000,China;不详)

机构地区：[1]辽宁中医药大学,沈阳110000 [2]辽宁中医药大学附属医院,沈阳110000

出　　处：《中国处方药》2024年第3期7-11,共5页Journal of China Prescription Drug

摘　　要：目的观察临床不同癌种患者在接受肿瘤细胞免疫检查点抑制剂治疗前后外周血中T淋巴细胞亚群的变化,探索其与不良反应发生相关性。方法回顾性收集2021年8月~2022年12月于辽宁中医药大学附属医院住院接受ICIs治疗的60例肿瘤患者的临床资料,对比接受ICI治疗前后的CD3^(+)、CD4^(+)、CD8^(+)计数及CD4^(+)/CD8^(+)的变化,分析T细胞亚群变化的影响因素。结果接受ICI治疗后CD3^(+)、CD4^(+)计数较前升高、CD4^(+)/CD8^(+)较前升高,差异具有统计学意义(P<0.05);虽CD8^(+)较前降低,但差异无统计学意义(P>0.05)。结果显示使用中药时间越长,CD4^(+)/CD8^(+)更趋近于正常范围0.7~2.78,同时不良反应出现的几率越低,irAEs分级越低。结论细胞病理免疫分析的T淋巴细胞结果或可作为临床指导预防免疫相关不良反应的指标之一,治疗过程中联合应用中药可显著降低临床不良反应。Objective To observe the changes of T lymphocyte subsets in peripheral blood of different cancer patients before and after tumor cell immune checkpoint inhibitor treatment,and to explore the correlation with adverse reactions.Methods The clinical data of 60 tumor patients receiving ICIs in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from August 2021 to December 2022 were collected retrospectively,comparing the changes of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD 8^(+)before and after ICI,and the influencing factors of T cell subsets were analyzed.Results CD3^(+),CD4^(+)counts and CD4^(+)/CD8^(+)after ICI were higher than those before treatment.The differences were statistically significant(P<0.05);although CD8^(+)decreased,the difference was not statistically significant(P>0.05).Among them,CD4^(+)/CD8^(+)with long time tended to approach the normal range of 0.7~2.78,and the lower the probability of adverse reactions,the lower the grade of irAEs.Conclusion The T lymphocyte results of ctopathological immunoassay may be used as one of the indicators of clinical guidance to prevent immune-related adverse reactions,and the combined application of traditional Chinese medicine during treatment can significantly reduce the clinical adverse reactions.

关 键 词：免疫治疗 不良反应 T细胞亚群 中医药 

分 类 号：R979.1[医药卫生—药品]