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目的观察对老年肝癌患者采用细胞免疫治疗联合注射用薏苡仁油(康莱特)对患者T细胞亚群及疾病预后的影响。方法选取2014年1月至2015年12月收治的老年原发性肝癌患者84例,随机分为治疗组及对照组各42例。对照组给予每日静脉滴注康莱特200 ml,21 d为1个疗程。治疗组同样剂量同样方法给予康莱特联合细胞免疫[树状突细胞-细胞因子诱导的杀伤细胞(DC-CIK),7 d为1个疗程]治疗。均治疗2个疗程。治疗结束后观察两组患者治疗前后的T细胞亚群水平变化,并对患者的生存质量进行行为状态评分(KPS),对疼痛情况进行评定。结果治疗前治疗组和对照组的CD3+、CD4+、CD8+、CD4+/CD8+比值和自然杀伤(NK)细胞比较,差异无统计学意义(P均>0.05),治疗后治疗组的CD4+、CD4+/CD8+比值和NK细胞升高、CD8+降低,且CD4+、CD4+/CD8+比值和NK细胞均高于对照组治疗后,差异均有统计学意义(P均<0.05)。治疗组KPS评分改善率为66.7%,对照组为45.2%,治疗组KPS行为评分明显优于对照组(P<0.05);治疗组疼痛缓解总有效率(CR+PR)为66.7%,对照组为45.2%,治疗组疼痛缓解情况明显优于对照组(P<0.05)。结论细胞免疫治疗联合康莱特对老年肝癌患者有良好的临床疗效,可提高患者免疫功能,改善疾病的预后。
Objective To observe the effect of intracranial immunotherapy combined with coix seed oil (Kanglaite) on T cell subsets and disease prognosis in elderly patients with hepatocellular carcinoma. Methods Eighty-four elderly patients with primary liver cancer who were admitted from January 2014 to December 2015 were randomly divided into treatment group (n = 42) and control group (n = 42). The control group received daily intravenous infusion of Kanglaite 200 ml, 21 d for a course of treatment. The same dose of the same treatment group was given Kanglaite combined with cellular immune [dendritic cells - cytokine-induced killer cells (DC-CIK), 7 d for a course of treatment] treatment. Treatment of 2 courses. After treatment, the change of T cell subsets in both groups before and after treatment was observed. And the quality of life of patients was assessed by KPS. Results There was no significant difference in the ratio of CD3 +, CD4 +, CD8 +, CD4 + / CD8 + and NK cells between the treatment group and the control group before treatment (all P> 0.05). The levels of CD4 +, CD4 + / CD8 + (P <0.05). The ratio of NK cells and CD8 + were decreased, and the ratio of CD4 +, CD4 + / CD8 + and NK cells were higher than that of the control group after treatment. The improvement rate of KPS score was 66.7% in the treatment group and 45.2% in the control group. The KPS score of the treatment group was significantly better than that of the control group (P <0.05). The CR + PR of the treatment group was 66.7% Was 45.2%, pain relief in the treatment group was significantly better than the control group (P <0.05). Conclusions Cellular immune therapy combined with KLT has a good clinical effect on elderly patients with hepatocellular carcinoma, which can improve immune function and improve disease prognosis.