用全身淋巴照射（TLI）治疗难治性类风湿性关节炎：免疫学和临床变化

Treatment of intractable rheumatoid arthritis with total lymphoid irradiation (TLI): immunological and clinical changes.

作者信息

Strober S, Field E M, Kotzin B L, Hoppe R T, Engleman E C, Tanay A S, Kaplan H S

出版信息

Radiother Oncol. 1983 Aug;1(1):43-52. doi: 10.1016/s0167-8140(83)80006-1.

Abstract

Eleven patients with intractable rheumatoid arthritis were treated with total lymphoid irradiation in a feasibility study. The mantle and the inverted Y fields were treated successively to a cumulative dose of 2000 rads. Nine of eleven patients showed at least a 35% improvement in three of four clinical parameters by six months and continued to maintain at least this level of improvement at their last observation points (13-28 months after TLI). There was a marked decrease in the percentage of total T cells and Leu-3 cells (helper), but an increase in the percentage of Leu-2 cells (suppressor/cytotoxic), resulting in a dramatic increase in the Leu-2/Leu-3 ratio. There was also a decrease in response to PHA, Con A and MLR.

摘要

在一项可行性研究中，对11例难治性类风湿关节炎患者进行了全淋巴照射治疗。先后对套区和倒Y野进行照射，累积剂量达2000拉德。11例患者中有9例在6个月时四项临床指标中的三项至少改善了35%，并在最后观察点（全淋巴照射后13 - 28个月）继续维持至少这一改善水平。总T细胞和Leu - 3细胞（辅助性T细胞）的百分比显著下降，但Leu - 2细胞（抑制性/细胞毒性T细胞）的百分比增加，导致Leu - 2/Leu - 3比值急剧上升。对PHA、Con A和混合淋巴细胞反应的应答也有所下降。