NSCLC患者T淋巴细胞、血液流变学检测与其化疗效果的关系  

Detection of T lymphocytes and blood rheology in patients with non-small cell lung cancer and their relationship with chemotherapy outcomes

作　　者：胡卫敏 苏彦娥 Hu Weimin;Su Yan'e(Department of Laboratory Medicine,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,Shaanxi Province,China)

机构地区：[1]陕西中医药大学附属医院检验科,咸阳712000

出　　处：《中国基层医药》2024年第6期824-828,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的分析非小细胞肺癌(NSCLC)患者的T淋巴细胞、血液流变学检测指标与其化疗效果的关系。方法纳入2021年5月至2023年5月陕西中医药大学附属医院就诊的NSCLC患者108例为观察组,另取同时间进行体检的健康者108例为对照组,均检测T淋巴细胞亚群及血液流变学指标,比较观察组化疗前与化疗后T淋巴亚群、血液流变学变化情况,以及化疗有效组与化疗无效组T淋巴亚群、血液流变学指标,进行NSCLC患者化疗无效的危险因素分析。结果观察组CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)均低于对照组,全血高切、中切、低切黏度及CD_(8)^(+)均高于对照组(t=22.64、32.29、28.72、24.53、28.29、18.72,均P<0.001);化疗后NSCLC患者全血高切、中切、低切黏度及CD_(8)^(+)较治疗前均显著下降,CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)较治疗前均显著上升(t=16.85、27.15、19.15、16.03、21.10、13.50,均P<0.001);化疗无效组全血高切、中切、低切黏度及CD_(8)^(+)分别为(6.08±0.67)mPa·s、(10.45±1.09)mPa·s、(15.59±1.61)mPa·s、(25.58±2.61)%,均显著高于化疗有效组的(4.86±0.51)mPa·s、(8.12±0.91)mPa·s、(11.86±1.28)mPa·s、(23.14±2.41)%,CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)分别为(37.82±3.96)%、(1.48±0.15),均显著低于化疗有效组的(40.05±4.14)%、(1.73±0.19)(t=10.24、11.36、11.52、4.65、2.56、6.55,均P<0.001);多因素法分析显示:全血高切、中切、低切黏度及CD_(8)^(+)是NSCLC患者化疗无效的独立危险因素(OR=1.425、1.697、1.705、1.719,均P<0.05),CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)是保护因素(OR=0.534、0.628,均P<0.05)。结论NSCLC患者普遍伴有T淋巴细胞亚群紊乱及血液流变学异常,且T淋巴细胞亚群、血液流变学指标是患者化疗疗效的影响因素,可用于此类患者的疗效评估。Objective To analyze the relationship between T lymphocytes and blood rheology test results in patients with non-small cell lung cancer(NSCLC)and their chemotherapy outcomes.Methods A total of 108 patients with NSCLC who received treatment in the Affiliated Hospital of Shaanxi University of Chinese Medicine between May 2021 and May 2023 were included in the observation group.A total of 108 participants who concurrently underwent physical examinations were included in the control group.T lymphocyte subsets and blood rheology indices were tested in both groups.In the observation group,T lymphocyte subsets and blood rheology indices were compared before and after chemotherapy.Additionally,T lymphocyte subsets and blood rheology indices were compared between the chemotherapy-effective group and the chemotherapy-ineffective group.The risk factors for ineffective chemotherapy in patients with NSCLC were analyzed.Results The CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)levels in the observation group were significantly lower than those in the control group,and whole blood viscosity in high-,medium-,and low-shear rates as well as CD_(8)^(+)level in the observation group were significantly higher than those in the control group(t=22.64,32.29,28.72,24.53,28.29,18.72,all P<0.001).After chemotherapy,whole blood viscosity at high-,medium-,and low-shear rates,as well as CD_(8)^(+)levels,significantly decreased in the observation group compared with pre-chemotherapy levels.Conversely,CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)levels significantly increased(t=16.85,27.15,19.15,16.03,21.10,13.50,all P<0.001).In the chemotherapy-ineffective group,whole blood viscosity in high-,medium-,and low-shear rates as well as CD_(8)^(+)level were(6.08±0.67)mPa·s,(10.45±1.09)mPa·s,(15.59±1.61)mPa·s,(25.58±2.61)%,respectively.These values were significantly higher than those in the chemotherapy-effective group[(4.86±0.51)mPa·s,(8.12±0.91)mPa·s,(11.86±1.28)mPa·s,(23.14±2.41)%,t=10.24,11.36,11.52,4.65,all P<0.001].CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)

关 键 词：癌 非小细胞肺 T淋巴细胞 血液流变学 抗肿瘤联合化疗方案 治疗结果 

分 类 号：R734.2[医药卫生—肿瘤]