调节性T淋巴细胞对急性期布鲁菌病患者治疗效果的影响  

Impact of regulatory T-lymphocytes on therapeutic efficacy of human acute brucellosis

作　　者：胡飞环[1] 张国侠[2] 田艳君[2] 张立杰[2] 刘佰玲[2] 王文敬[1] 黎诚耀[1] 

机构地区：[1]南方医科大学检验与生物技术学院输血医学系,广州510515 [2]黑龙江省农垦总医院感染科

出　　处：《中华传染病杂志》2017年第3期129-133,共5页Chinese Journal of Infectious Diseases

基　　金：国家自然科学基金（31372443）;广东省科技计划（2014A020214003）

摘　　要：目的调查布鲁杆菌感染后宿主的体液和细胞免疫应答情况，Foxp3^＋在布鲁菌病患者治疗过程中的变化，阐明宿主产生免疫抑制对布鲁菌病治疗效果的影响。方法2015年7月至2015年11月，黑龙江农垦总局总医院感染三科住院的急性期布鲁菌病患者65例。标准治疗组28例，根据患者情况选择抗菌药物进行3个疗程的标准治疗，每个疗程20d，疗程间隔10d；免疫增强剂组37例，在标准治疗的基础上增加免疫增强药物。另选取健康体检者30名为健康对照组。在治疗前和每个疗程结束时，采用流式细胞术检测患者外周血中CD3^＋CD4^＋Foxp3^＋Treg含量变化。符合正态分布的数据以孑±S表示。两组间比较采用t检验，多组问的比较采用方差分析，组间两两比较采用SNK法。不符合正态分布的数据进行多个独立样本的非参数检验。结果65例急性期布鲁菌病患者第1疗程结束时外周血中Foxp3^＋ Treg含量为2．83％，第2疗程结束时为3．77％，第3疗程结束时为4．03％，均高于健康对照组的1．69％（￡值分别为5．97、9．05和5．66，均P〈0．01）。第1疗程结结束时，标准治疗组和免疫增强剂组间外周血Foxp3^＋Treg含量差异无统计学意义（t=0．33，P〉0．05），但均高于健康对照组（￡值分别为7．09和4．94，均P〈0．01）。第2疗程结束时，免疫增强剂组患者外周血Foxp3^＋Treg含量高于标准治疗组，差异有统计学意义（t=2．22，P〈0．01），且两组均高于健康对照组（f值分别为10．79和7．25，均P〈0．01）。第3疗程结束时，免疫增强剂组患者外周血Foxp3^＋ Treg含量高于标准治疗组和健康对照组，差异均有统计学意义（t值分别为6．02和6．45，P〈0．01）。结论急性期布鲁菌病患者经过添加免疫增强剂的治疗，外周血Foxp3^＋Treg含量呈现持续上升的趋势，并一直维持在一定高位水平。推测，过�Objective To investigate the humoral and cellular immune responses in patients with acute brucellosis, and evaluate dynamic changes of regulatory T-lymphocytes （Foxp3^＋ Treg） in the peripheral blood of patients during treatment, in order to clarify the relationship between immunosuppression and the therapeutic effect in human brucellosis. Methods Sixty-five patients with brucellosis hospitalized at the Third Department of Infectious Diseases, Heilongjiang Agriculture and Reclamation Bureau General Hospital between July 2015 and November 2015 were included. Twenty-eight patients were treated with conventional therapy （group A： patients received 3 courses of treatment. Each lasted for 20 days with one week interval）, and 37 patients were treated with conventional therapy in combination with immunopotentiator （group B）. Thirty healthy volunteers were enrolled as the controlled group. The ratio of CD3^＋ CD4^＋ Foxp3^＋ Treg cells in the peripheral blood of brucellosis patients were measured by flow cytometry （FCM） at the end of each course of treatment. Data in accordance with normal distribution were described as mean± standard deviation. Comparison between two groups was done by two sample t test. Comparison among multiple groups was performed by analysis of variance and SNK test. Data that did not fit the normal distribution were analyzed by multiple-sample nonparametric test. Results After the first （20 d）, second （50 d） and third course of treatment （80 d）, the ratios of Foxp3^＋ Treg in the peripheral blood of 65 acute brucellosis patients were 2.83%, 3.77% and 4.03%, respectively, which were all significantly higher than control group （1. 69%; t=5.97, 9.05 and 5.66, respectively, all P〈0.01）. At the end of the first course of treatment, the ratios of Foxp3^＋ Treg in group A and B showed no statistically difference （t=0.33, P〈0.05）, while those were both higher than control group （t=7.09 and 4.94, respectivelyl both P〈0.01）. At the end of the second cour

关 键 词：布鲁菌属 布鲁菌病 治疗 流式检测 T淋巴细胞 调节性 FOXP3 

分 类 号：R516.7[医药卫生—内科学]