肺结核患者外周血CD4^+T淋巴细胞凋亡与细胞因子相关性及临床意义研究  

Study of the correlation between CD4^+T lymphocyte apoptosis and cytokines and its clinical significance in patients with pulmonary tuberculosis

作　　者：陈廷[1] 董海新[2] 陈新科[2] 侯春生[3] 石俊仕[4] 赵月霞[5] 聂尚丹[6] 张孝侠[6] 李雷生[6] 

机构地区：[1]济宁医学院继续教育学院,山东济宁272000 [2]济宁医学院附属医院 [3]济宁市传染病院 [4]济宁市结核病防治所 [5]济宁市第一人民医院 [6]济宁医学院医学检验系

出　　处：《中国病原生物学杂志》2012年第2期98-100,104,共4页Journal of Pathogen Biology

基　　金：济宁市科技局资助项目

摘　　要：目的探讨肺结核患者外周血CD4+T淋巴细胞凋亡与血清IL-4、IL-6、TGF-β的相关性及其临床意义。方法分离结核病患者和健康者外周血单个核细胞,标记后用流式细胞仪测定CD4+T淋巴细胞凋亡率;采用酶联免疫吸附试验测定42例肺结核患者及28例健康人群血清IL-4、IL-6、TGF-β水平。结果结核病患者外周血CD4+T淋巴细胞凋亡率(15.8820±4.6500)显著高于对照组(7.9389±4.16564)(t=7.491,P<0.01),血清IL-4水平(0.6219±0.78565)较对照组(0.2120±0.07367)显著升高(t=2.732,P<0.05)。肺结核患者中涂阳组IL-6水平(0.0602±0.01833)较涂阴组(0.0905±0.05023)显著升高(t=-2.296,P<0.05),TGF-β水平复治组(0.1128±0.04704)较初治组(0.0748±0.01659)显著升高(t=-3.019,P<0.05)。外周血CD4+T淋巴细胞凋亡率与IL-4水平呈正相关(r=0.366,P<0.05);血清IL-6的含量与TGF-β的含量呈正相关(r=0.829,P<0.01)。结论结核病患者CD4+T淋巴细胞凋亡率显著增加,可能与肺结核感染免疫有关;IL-4、IL-6和TGF-β是抗结核感染免疫的重要调节因子,其血清水平可作为监测病情活动和转归的重要指标。Objective To detect the apoptosis of CD4^＋T lymphocytes in patients with pulmonary tuberculosis and ascertain the clinical significance of levels of IL-4,IL-6,and TGF-β in the sera of patients with TB.Methods Mononuclear cells in the blood of patients with tuberculosis and healthy individuals were separated.Flow cytometry was used to measure the percentage of apoptotic CD4^＋T lymphocytes.ELISA was used to determine the levels of IL-4,IL-6,and TGF-β in sera from 42 patients with TB and 28 healthy individuals.Results The rate of apoptosis of CD4^＋T lymphocytes from patients with tuberculosis（15.8820±4.6500） was significantly higher than the rate of apoptosis of lymphocytes from controls（7.9389±4.16564）（t=7.491,P〈0.01）.The level of IL-4 increased in patients with TB（0.6219±0.78565） compared to the control group（0.2120±0.07367）（t=2.732,P〈0.05）.There was an increase in serum IL-6 in patients with a positive smear（0.0602±0.01833） compared to patients with a negative smear（0.0905±0.05023）（t=-2.296,P〈0.05）.The level of TGF-β increased in patients treated repeatedly（0.1128±0.04704） compared to parents treated initially（0.0748±0.01659）（t=-3.019,P〈0.05）.Differences in these levels were all statistically significant.There was a positive correlation between the rate of apoptosis of CD4^＋T lymphocytes and the level of IL-4（r=0.366,P〈0.05） and between the level of IL-4 and the level of TGF-β（r=0.829,P〈0.01）.Conclusion The rate of apoptosis of CD4^＋T lymphocytes in patients with tuberculosis was significantly higher than in healthy individuals.This apoptosis may be associated with the immune response to tuberculosis.IL-4,IL-6,and TGF-β play an important role in the immune system＇s response to pulmonary tuberculosis.Serum levels can act as a useful index to monitor the state of the illness and its prognosis.

关 键 词：肺结核患者 CD4+T淋巴细胞 细胞凋亡 IL-4 IL-6 TGF-Β 

分 类 号：R521[医药卫生—内科学]