肺结核患者T细胞亚群比例和相关细胞因子的动态变化及临床意义  

Dynamic changes and clinical significance of subpopulation of T lymphocytes and related cytokines in patients with pulmonary tuberculosis

作　　者：夏宁[1] 张宇[1] 侯志波[1] 郝可可[1] 

机构地区：[1]南京市胸科医院呼吸病科,江苏省210029

出　　处：《江苏医药》2015年第22期2684-2687,共4页Jiangsu Medical Journal

摘　　要：目的探讨肺结核患者T细胞亚群比例和相关细胞因子的动态变化及临床意义。方法采用流式细胞术检测肺结核患者(观察组,48例)和健康志愿者(对照组,48例)外周血CD3+、CD4+和CD8+T细胞比例,ELISA法测定两组血清IL-4、IL-10、TNF-α和IFN-γ的表达。观察组依据病灶累及范围分为多叶受累组(24例)和病灶局限组(24例)。结果治疗前,观察组CD4+T细胞比例及CD4+/CD8+比值低于对照组(P<0.05),治疗后较治疗前增加,但仍低于对照组(P<0.05)。治疗前,观察组血清IL-10与TNF-α水平高于对照组(P<0.05),治疗后两组无统计学差异。多叶受累组CD4+T细胞比例、CD4+/CD8+比值和IFN-γ水平均低于病灶局限组(P<0.05),TNF-α水平高于病灶局限组(P<0.05)。结论 T细胞亚群比例和相关细胞因子的表达水平反映肺结核患者免疫功能和病情严重程度。Objective To investigate the dynamic changes and clinical significance of subpopulation of T lymphocytes and related cytokines in the patients with pulmonary tuberculosis（PT）.Methods The proportion of peripheral blood CD3^＋,CD4^＋,CD8^＋T lymphocytes and the expressions of serum IL-4,IL-10,TNF-αand IFN-γwere detected by flow cytometry and ELISA in 48 PT patients（group A）and 48 healthy volunteers（group C）.Group A was then divided into 2 subgroups of A1（involving two or more lobes,24cases）and A2（involving single lobe,24 cases）.Results The proportion of CD4^＋T lymphocytes and CD4^＋/CD8^＋ratio were lower in group A than those in group C before treatment（P〈0.05）,which after treatment were increased but still lower than those in group C（P〈0.05）.Serum levels of IL-10 and TNF-αwere higher in group A than those in group C before treatment（P〈0.05）,which after treatment showed no significant differences between two groups.The proportion of CD4^＋T lymphocytes,CD4^＋/CD8^＋ ratio and serum IFN-γlevel were lower,while serum TNF-αlevel was higher in subgroup A1 than those in subgroup A2（P〈0.05）.Conclusion The proportion of subgroups of T lymphocytes in peripheral blood and serum levels of related cytokines reflect the immune function and the severity of the disease in TB patients.

关 键 词：T淋巴细胞 细胞因子 肺结核 免疫功能 

分 类 号：R521[医药卫生—内科学]