不同时期卡介苗免疫治疗对结核病大鼠疗效和CD4^+CD8^+双阳(DP)T细胞的影响  

The different influence of BCG vaccination to the treatment effect of rats with tuberculosis and to the peripheral blood T lymphocyte subset at different period

作　　者：雷建平[1] 彭燕[2] 熊国亮[1] 张玉珍[3] 周军[1] 刘翼军[1] 邢娟娟[2] 李光明[1] 雷铭宙[1] 袁小亮[1] 涂荣耀[1] 涂少华[1] 

机构地区：[1]江西省胸科医院,南昌330006 [2]南昌大学第一附属医院流式细胸室,南昌330006 [3]南昌大学医学院动物科学部,南昌330006

出　　处：《中国防痨杂志》2006年第6期404-407,I0003,共5页Chinese Journal of Antituberculosis

基　　金：江西省社会发展攻关重点基金(2004-社发攻关-07)

摘　　要：目的探讨不同时期给予卡介苗(BCG)免疫治疗对结核病化疗效果和T细胞严群的影响。方法80只PPD皮试阴性SD大鼠随机分成(1)化疗开始同步加BCG治疗组;(2)化疗1月后加BCG治疗组;(3)单纯化疗对照组;(4)模型效果判断组。各组于实验开始接受结核杆菌(Mtb)攻毒;第1个月末处死模型效果判断组全部大鼠作病理学和结核杆菌细菌学检查,其他各组于第1个月末接受抗结核化疗,其中第1组化疗开始加用BCG治疗,第2组化疗1个月后加用BCG治疗。观察各组大鼠死亡率;检测各组大鼠于Mtb攻毒前和Mtb攻毒后1、2、3、5个月末的外周血中CD3+、CD4+、CD8+、DPT细胞含量,第2、5个月末加查淋巴细胞绝对计数。结果(1)Mtb感染后1个月内1、3、4组各死亡2只大鼠,第2组死亡1只大鼠。化疗开始后4个月治疗期死亡率:化疗一开始即同步加BCG治疗组22.2%(4/18)高于化疗1月后加BCG治疗组(0/19),P<0.05;化疗对照组为5.6%(1/18),(2)结核病鼠表现为CD4/CD8比值(可伴CD4+细胞)降低、CD8+(可伴DP)细胞升高,P<0.05或P<0.01;这种改变可在化疗后1~2个月内恢复到接近正常水平。(3)化疗开始同步加用BCG组治疗1个月时表现为T淋巴细胞(CD3+)、CD4+T细胞百分率显著降低,而淋巴细胞绝对计数和CD8+、DPT细胞百分率升高,P<0.05或P<0.01;治疗2个月后CD3+、CD4+T细胞恢复到正常范围而仍保持CD8+、DPT细胞较高水平。(4)化疗1个月后再加用BCG组在加用BCG后表现为CD3+、CD4+细胞百分率不降低而CD8+、DP细胞升高。结论淋巴细胞总数显著升高而T细胞占总淋巴细胞百分率显著降低是化疗开始同步加BCG治疗组第一个月死亡率升高的一个重要免疫学特征。DP细胞是抗结核保护性免疫相关细胞。BCG作结核病的免疫治疗应在化疗1个月后开始。Objective To investigate the different influence of BCG vaccination to the anti-tuberculosis treatment and to the peripheral blood T lymphocyte subset at different period. Methods 80 SD rats with PPD skin-test negative were randomly divided into 4 groups： group 1 started BCG at the same time that the treatment started, group 2 started BCG after the treatment started for 1 month, group 3 was the control group, group 4 was to judge the effect of the model. Every rat was injected a dose of 108 CFU mycobacterium tuberculosis （Mtb） at beginning of the observation. At the end of the 1st month, the rats of the group 4 were killed to conduct pathological and tuberculosis bacterial examinations, while the rats of group 1, 2 and 3 were given anti-tuberculosis chemotherapy. Group 1 was given BCG vaccination at the beginning of anti-tuberculosis chemotherapy, group 2 was given BCG vaccination after anti-tuberculosis chemotherapy stared for one month Mortality of each group was measured. CD3 ^＋ , CD4^ ＋ , CD8 ^＋ and DP T lymphocytes in peripheral blood of rats were measured at the beginning and the end of lst,2nd,3rd and 5th month of experiment. Absolute value of peripheral blood lymphocyte of the rats in group 1, 2 and 3 were examined at the 2nd month and the 5th month of experiment. Results （1） Within 1 month of the injection of Mtb, 2 rats died in group 1, 3 and 4 and 1 rat died in group 2. Mortality after 4 - month of anti-tuberculosis chemotherapy： group 1 was 22.2% （4/18） which was higher than that of group 2 （0/19, P 〈 0.05）. Mortality of group 3 was 5.6% （1/18）. （2） The value of CD4/CD8 decreased and the level of CD8^＋ cell increased （ P 〈 0.05 or P 〈 0.01） . （3）In group1, the percentage of T cell （CD3^＋ ） and CD4 ^＋ decreased, while the lymphocyte absolute value and the percentage of CD8^ ＋ , DP T cell increased （ P 〈 0.05 or P 〈0.01）; after the treatment for 2 months, the level of CD3^＋ , CD4^＋ T lymphocytes was at normal level while CD8^＋ and

关 键 词：结核 细胞免疫学 T细胞亚群 BCG 免疫治疗 

分 类 号：R52[医药卫生—内科学]