肺结核患者外周血低密度粒细胞检测的临床意义  

The expression and clinical significance of low-density granulocytes in peripheral blood of patients with pulmonary tuberculosis

作　　者：黄自坤[1] 姚芳苡 邓亚婷[1] 罗清[1] 熊国亮[3] 李俊明[1] HUANG Zikun YAO Fangyi DENG Yating YE Jianqing LUO Qing XIONG Guoliang LI Junming(Department of Clinical Laboratory, First Affiliated Hospital of Nanchang University, Nanchang 330006, China Department of Clinical Laboratory, Jiangxi Province Blood Center, Nanchang 330006, China Department of Clinical Laboratory, Jiangxi Chest Hospital, Nanchang 330006, China)

机构地区：[1]南昌大学第一附属医院检验科,330006 [2]江西省血液中心检验科,南昌330006 [3]江西省胸科医院检验科,南昌330006

出　　处：《免疫学杂志》2017年第1期40-45,共6页Immunological Journal

基　　金：国家自然科学基金(81560001);江西省青年科学基金(20142BAB215057);江西省教育厅科技项目(GJJ14176);江西省科技厅科技支撑计划(20151BBG70208);江西省卫生和计生委科技项目(20161018)

摘　　要：目的探讨肺结核(TB)患者外周血低密度粒细胞(LDGs)的比例变化及其意义。方法采用流式细胞术分析80例TB患者及25例健康体检者外周血单个核细胞(PBMCs)层中CD14^(low)CD15^+LDGs的比例及变化情况,检测LDGs表面CD15、CD16、CD33、CD66b、CD62L的表达水平、凋亡坏死率及ROS水平。分析LDGs与TB发生发展以及转归的相关性。结果 TB患者外周血PBMCs层中LDGs的比例显著高于健康对照组(P<0.01);痰涂片抗酸阳性的TB患者LDGs的比例显著高于抗酸阴性者(P<0.01)。与TB患者正常密度粒细胞(NDGs)比较,TB患者LDGs表面CD15、CD33、CD66b表达量显著升高,CD62L的表达量显著下降,凋亡率上调,ROS水平上调。LDGs的比例在肺部有无空洞及空洞数量分组之间差异有统计学意义(P<0.05),即LDGs的比例随空洞累及范围的增加而升高。TB患者经抗痨治疗后,外周血LDGs的比例随治疗时间延长而下降,治疗3个月后,LDGs的比例显著降低,治疗6个月后与健康对照组无明显差异。结论 LDGs水平在TB患者外周血中显著上调,TB患者外周血中的LDGs为一群发生脱颗粒的活化中性粒细胞,且与TB的严重程度相关。To explore expression and clinical significance of low-density granulocytes （LDGs） in pulmonary tuberculosis （TB） patients, the frequency of CD14lowCD15＋ LDGs in the peripheral blood mononuclear cells （PBMCs） of 80 hospitalized TB patients and 25 healthy controls were recruited in this study. The expression levels of phenotypic markers including CD15, CD16, CD33, CD66b and CD62L, the levels of intraeellular ROS and apoptosis ratios of LDGs and autologous NDGs were detected by flow cytometry. The correlation between LDGs frequency and disease severity was also evaluated. Data showed that the PBMCs of subjects with TB contained significantly elevated percentages of LDGs compared with the PBMCs of control subjects, and the percentages of LDGs in the PBMCs with positive AFB （acid-fast bacillus） were significantly elevated, as compared with patients with negative AFB （P〈0.01）. When compared to NDGs from health control, the mean fluorescence intensities （MFI） of membranal CD15, CD33, CD66b, and ROS were significantly enhanced and CD62L was significantly reduced on LDGs frompatients with TB. The levels of LDGs were correspondingly higher when lung cavitation existed and when the cavitation was increased in size （P〈0.05）. The percentages of LDGs in the PBMCs of TB patients were significantly decreased after 2 weeks of anti-tuberculous therapy, and recovered to the levels ofhealthy volunteers after 6-months of anti-tuberculous therapy. In conclusion, LDGs, a group of activated and degranulated neutrophils, is significantly elevated in TB patients and is correlated with the severity of tuberculosis.

关 键 词：肺结核 流式细胞术 低密度粒细胞 

分 类 号：R521[医药卫生—内科学] R446.1[医药卫生—临床医学]