心理干预及癌痛规范化治疗对癌症患者T细胞表面PD―1Tim―3影响.docVIP

心理干预及癌痛规范化治疗对癌症患者T细胞表面PD―1Tim―3影响 　　[摘要] 目的 探究心理干?A及癌痛规范化治疗对癌症患者T细胞表面PD-1、Tim-3的影响。方法 方便选取2015年6月―2016年11月该院接受规范化镇痛治疗的80例癌痛患者，按随机数字表法分为研究组和对照组，每组40例。两组患者均接受规范化癌痛治疗，对照组实施常规护理，研究组接受心理医师的心理干预。采用疼痛强度数字分级法（NRS）评价两组患者治疗前后的疼痛情况；流式细胞仪检验两组患者治疗前后外周血CD4+T细胞和CD8+T细胞表面PD-1和Tim-3表达情况。结果 NRS评分统计显示，研究组与对照组治疗前分别为（4.76±1.10）分和（4.75±0.91）分，治疗后分别为（1.31±0.42）分和（2.03±0.71）分，治疗后研究组患者的NRS评分显著低于对照组，差异有统计学意义（P0.05）；治疗后研究组患者CD4+T细胞表面PD-1、Tim-3表达水平显著低于对照组，CD8+T细胞表面PD-1水平显著低于对照组，差异有统计学意义（P0.05）。结论 心理干预联合癌痛规范化治疗能够有效的减轻患者的疼痛程度，同时能够影响T细胞亚群的分布，降低癌痛患者外周血中Tim-3+、PD-1+表达的T细胞数量，提高患者的免疫力，减轻患者的疼痛。 　　[关键词] 癌症；免疫细胞；PD-1；Tim-3；规范化治疗；心理干预 　　[中图分类号] R714 [文献标识码] A [文章编号] 1674-0742（2017）03（b）-0037-04 　　[Abstract] Objective To study the effect of mental intervention and standardized treatment of cancer pains on the T cell surface PD-1 and Tim-3 of cancer patients. Methods Convenient selection 80 cases of cancer pain patients treated with standardized analgesia in our hospital from June 2015 to November 2016 were selected and randomly divided into two groups with 40 cases in each， both groups received the standardized treatment of cancer pains， the control group adopted the routine nursing， while the research group adopted the mental intervention of psychologists， and the pain degree before and after treatment of the two groups was evaluated by NRS， and the peripheral blood CD4+T cell and expression of CD8+T cell surface PD-1 and Tim-3 before and after treatment of the two groups was tested by the flow cytometer. Results The NRS score in the research group and in the control group before treatment was respectively （4.76±1.10）points and （4.75±0.91）points and （1.31±0.42 ）points and （2.03±0.71）points after treatment， and the NRS score in the research group was obviously lower than that in the control group after treatment， and the difference had statistical significance（P0.05）， after treatment， the expression level of CD4+T cell surface PD-1 and Tim-3 in the research group was obviously lower than that in the