不同肺结核类型患者细胞免疫功能相关性研究  

Related research on cellular immune function in patients with different types of tuberculosis

作　　者：商勇[1] 陆燕春[1] 解承鑫 李玉玺[1] 迪拉拉 沙吉旦[1] 桑晓东[1] 陈云[1] 

机构地区：[1]喀什地区第一人民医院呼吸二科,新疆喀什844000

出　　处：《临床肺科杂志》2017年第7期1176-1179,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究不同肺结核类型患者病变范围及程度对细胞免疫功能产生的临床影响。方法选取2015年5月至2016年4月在我院的116例结核病住院患者,其中男∶女=67∶49。根据肺结核类型,将所有患者分为初治肺结核组(42例)、肺外结核组(41例)和复治肺结核组(33例)。采集所有患者的外周血,分别检测CD4^+、CD8^+、CD4^+/CD8^+、可溶性白细胞介素-2受体(sIL-2R)以及γ-干扰素在各个结核组的实验值,并进行统计学分析。结果外周血CD4^+/CD8^+比较上,初治肺结核组>复治肺结核>肺外结核组,差异均有统计学意义(P<0.05)。复治肺结核组和肺外结核组血清s IL-2R和γ-干扰素显著高于初治肺结核组,差异均有统计学意义(P<0.01)。1-2个病灶肺野组外周血CD^+4/CD^+8显著高于3-4个病灶肺野组和5-6个病灶肺野组。而1-2个以及3-4个病灶肺野组血清s IL-2R和γ-干扰素则明显低于5-6个病灶肺野组,差异均有统计学意义(P<0.01)。结论与初治肺结核患者相比,复治或肺外结核患者的细胞免疫功能均明显下降。T细胞亚群中CD^+4/CD^+8等指标可为临床上不同类型肺结核病患者提供疾病预后的重要预测参考。Objective To study the clinical influence of disease extent and severity on cellular immune function in patients with different types of tuberculosis. Methods From May 2015 to April 2016, 116 inpatients with tu-berculosis in our hospital were selected. The ratio of male to female was 67 ： 49. According to the type of pulmonary tuberculosis, all patients were divided into the newly diagnosed pulmonary tuberculosis group （42 cases） , the extra-pulmonary tuberculosis group （41 cases） and the retreated pulmonary tuberculosis group （33 cases）. The levels of CD8, CD4^＋/CD8^＋ , soluble interleukin-2 receptor （ sIL-2R） and interferon-γ in peripheral blood were measured and analyzed. Results The value of CD4^＋/CD8^＋ ratio in peripheral blood was the highest in the newly diagnosed pulmo-nary tuberculosis group, followed by the untreated pulmonary tuberculosis group and the extra-pulmonary tuberculosis group （ P 〈 0. 05 ）. The serum levels of sIL-2R and interferon-γ were obviously higher in the retreated pulmonary tu-berculosis group and the extra-pulmonary tuberculosis group than in the newly diagnosed pulmonary tuberculosis group （P 〈 0. 01） . However, serum sIL-2R and IFN-γ in 1 - 2 lung lesions and 3-4 lesions were significantly lower than those in 5 - 6 lung fields （ P 〈 0. 01） . Conclusion Compared with newly diagnosed pulmonary tuberculosis pa-tients, the cellular immune function of re-treated or extra-pulmonary tuberculosis patients decreases significantly. CD4^＋/CD8^＋ in T cell subsets can be an important predictor of disease prognosis in patients with different types of pul-monary tuberculosis.

关 键 词：肺结核 细胞免疫功能 相关性 病变范围 

分 类 号：R521[医药卫生—内科学]