初治骨关节结核患者外周血T细胞亚群特点及临床意义  

The characters and clinical significance of T lymphocyte subsets in peripheral blood of new patients with osteoarticniar tuberculosis

作　　者：管波清[1] 林羽[1] 吴启秋[1] 宋长兴[1] 

机构地区：[1]北京市结核病胸部肿瘤研究所骨科,101149

出　　处：《中华骨科杂志》2007年第4期287-291,共5页Chinese Journal of Orthopaedics

摘　　要：目的 探讨初治骨关节结核患者外周血T细胞亚群特点、与临床观测指标的关系及抗结核治疗对患者细胞免疫状况的影响。方法 采用单平台流式细胞术检测骨关节结核患者治疗前和治疗后1-2个月T细胞亚群的绝对数及百分比，并与恶性骨肿瘤患者和健康人比较。结果 初治骨关节结核组CD4及CD8T细胞绝对数较健康对照组低（P〈0．01）。骨关节结核患者在治疗1-2个月后CD4T细胞百分比升高（P〈0．05）。青年组CD8T细胞绝对数和百分比显著高于中年组和老年组（P〈0．05，P〈0．01），CD4／CD8显著低于中年组及老年组（P〈0.01）。T细胞亚群各参数与PPD反应直径、红细胞沉降率和C反应蛋白之间无显著相关性（P〉0．05）。脊柱结核合并脓肿组CD4／CD8较低，CD8T细胞百分比较高（P〈0．01）。结论 初治骨关节结核患者存在细胞免疫缺陷，以中老年组更明显。脊柱结核是否形成脓肿与CD8T细胞有关。初治骨关节结核患者经1～2个月化疗后，细胞免疫状况改善，是病灶清除术的有利时机．Objective To investigate the features, changes of T lymphocyte subsets in peripheral blood of new patients with osteoarticular tuberculosis pre- and post antituberculosis treatment and to investigate their correlations to clinical factors. Methods The absolute counts and percentages of lymphocyte subsets in pre-treatment and 1 month post-treatment cases with osteoarticular tuberculosis were detected by single-platform flow cytometry. T lymphocyte subsets in osteoarticular tuberculosis patients were compared with those in patients with malignant primary or metastatic bone tumor and normal controls. Results The absolute counts of CD4 and CD8 T lymphocyte in osteoarticular tuberculosis patients were significantly lower than those in normal controls and malignant bone tumor patients （P〈 0.01）. The percentages of CD4 T lymphocytes were significantly higher in 1-2 months post-treatment patients than those in pre-treatment patients （P〈 0.05）. The levels of absolute counts and percentage of CD8 T lymphocytes in adolescent patients were significantly higher than those in middle-aged and elderly patients （P〈 0.05, P〈 0.01）. The levels of CD4/CD8 ratio in adolescent patients were significantly lower than those in middle-aged and elderly patients （P〈 0.01）. No significant correlations were found between T lymphocyte subsets values and diameter of induration of PPD test, ESR or CRP in new cases with osteoarticular tuberculosis（P 〉0.05）. The percentages of CD8 T lymphocytes and the CD4/CD8 ratio in spinal tuberculosis patients with abscesses were significantly higher than those without abscesses（P〈 0.01）. Conclusion The cell-mediated immunity in new patients with osteoarticular tuberculosis, especially in middle-aged and elderly patients, is lower than that in normal controis. The appearance of abscesses in spinal tuberculosis patients is correlated to CD8 T lymphocyte. The cell-mediated immunity in osteoarticular tuberculosis patients after 1-2 months therapy presents an ascending tendenc

关 键 词：结核 骨关节 T淋巴细胞亚群 免疫 细胞 CD4阳性T淋巴细胞 CD8阳性T淋巴细胞 

分 类 号：R686[医药卫生—骨科学]