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目的探讨外周血及胸水CD4+CD25+调节T细胞(Treg)在平阳霉素(PYM)胸膜固定术中的变化及临床意义。方法 23例肺癌并发恶性胸腔积液(MPE)患者给予PYM胸膜固定术,对固定术前及术后48h外周血及胸水采用流式细胞术观察Treg变化。结果 23例患者治疗4周后,有效14例,无效9例,有效率60.87%。有效组男11例,女3例,无效组男6例,女3例,两组给药前年龄、KPS评分、Treg在血及胸水中比较均无差异。术后患者血及胸水Treg较术前明显减低(血Treg:P=0.019;胸水Treg:P=0.039)。有效组给药后血Treg降低显著(P=0.010),胸水Treg降低不显著(P=0.092);无效组血和胸水Treg降低均不明显。结论 PYM胸膜固定术可有效控制MPE,其疗效与PYM显著减少血Treg,促进炎症反应有关。
Objective To investigate the changes and clinical significance of CD4 + CD25 + regulatory T cells (Treg) in pleurodesmil (PYM) pleurodesis in peripheral blood and pleural effusion. Methods Twenty - three patients with lung cancer complicated with malignant pleural effusion (MPE) were treated with PYM pleurodesis. Treg changes were observed by flow cytometry before and 48 h after operation in peripheral blood and pleural effusion. Results After treatment for 4 weeks, 23 patients were effective in 14 cases, 9 cases were ineffective, and the effective rate was 60.87%. There were 11 males and 3 females in effective group, 6 males and 3 females in invalid group. There was no difference in KPS score, Treg between blood and pleural effusion before treatment in both groups. Treg in blood and pleural effusion were significantly lower than those before operation (blood Treg: P = 0.019; pleural effusion Treg: P = 0.039). Treg decreased significantly in the effective group (P = 0.010), but not in the pleural effusion (P = 0.092). The decrease of Treg in blood and pleural effusion was not significant in the effective group. Conclusion PYM pleurodesis can effectively control MPE, and its curative effect is related to PYM significantly reducing blood Treg and promoting inflammatory reaction.