脾氨肽辅助治疗对小儿喉乳头状瘤 T 淋巴细胞亚群变化及疗效的影响简

目的 探讨小儿喉乳头状瘤（JLP）患儿外周血T淋巴细胞（简称T细胞）亚群的变化及脾氨肽对JLP患儿T细胞亚群的影响和疗效。方法 60例JLP病例随机分为JLP联合治疗组（30例）和JLP手术组（30例），所有JLP患者均采用喉内镜下电动吸割器切除新生物，联合治疗组术后同时口服脾氨肽辅助治疗，手术组不加任何免疫治疗。以同期体检的20例健康儿童做对照组，对 JLP病例组（未治疗前）、健康对照组、JLP联合治疗组和JLP手术组进行外周血T细胞亚群的检测，并对脾氨肽辅助治疗JLP的疗效进行分析。结果 治疗前JLP病例组CD3＋T细胞、 CD4＋T细胞百分率及CD4＋ /CD8＋T细胞比值较健康对照组降低，差异有统计学意义（P〈0.05）；治疗后JLP联合治疗组CD3＋T细胞、 CD4＋T细胞百分率明显升高（P〈0.05），CD4＋ /CD8＋T细胞比值恢复平衡；治疗后JLP联合治疗组较JLP手术组的疗效明显提高（P〈0.05）。结论 JLP患儿存在T细胞介导的免疫功能障碍，脾氨肽可恢复JLP患儿T细胞亚群的正常比例，改善患儿的细胞免疫功能，对JLP有较好的辅助治疗作用。

Changes of T-lymphocyte subsets in peripheral blood of children with juvenile-onset laryngeal papilloma and the adjuvant effect of spleen aminopeptide

Objective To investigate the Changes of T-lymphocyte subsets in peripheral blood of children with juvenile onset laryngeal papilloma （JLP）and the adjuvant effect of spleen aminopeptide. Methods Sixty children with JLP were randomly divided into group A and group B, with thirty patients in each group. All of the JLP had been removed with electric suction cutter under laryngeal endoscope.The children in group A were treated with operation combined with spleen aminopeptide taken orally while the others in group B accepted operative treatment only. Twenty healthy children who had physical examination during the same period were enrolled as the control group.Flow cytometric analysis was employed to study T-lymphocyte subsets in Peripheral Blood of 60 children with JLP and 20 healthy controls. Results Before treatment, the percentage of CD3＋T, CD4＋T lymphocyte subsets and the ratio of CD4＋ /CD8＋of the JLP children were all significantly lower than those of the healthy control group （P〈0.05）. The percentage of CD3＋T, CD4＋T lymphocyte subsets and the clinical efficacy in JLP children after treatment with spleen aminopeptide were all significantly increased （P〈0.05）, while the ratio of CD4＋ /CD8＋T returned to normal. Conclusions The T-lymphocyte subsets mediated cellular immune function is depressed in children with JLP. Treatment with spleen aminopeptide can recover the imbalance of the ratio of T-lymphocyte subsets and improve the cellular immune function in JLP children, and has a good adjuvant effect for JLP.