肺结核患者外周血CD4+T细胞数在预测疗效中的价值  

Predictive value of CD4+ T cell counts in peripheral blood in pulmonary tuberculosis therapy

作　　者：李茜[1] 秦溧嫔 田小星 李冰洁 钱克莉 Li Qian;Qin Lipin;Tian Xiaoxing;Li Bingjie;Qian Keli(Department of Infectious Diseases,the Fifth People’s Hospital of Chongqing,Chongqing 400062,China)

机构地区：[1]重庆市第五人民医院感染科,400062

出　　处：《国际流行病学传染病学杂志》2019年第3期208-210,共3页International Journal of Epidemiology and Infectious Disease

基　　金：重庆市南岸区卫生计生委科研项目(2017-38).

摘　　要：目的探讨肺结核患者强化治疗期CD4^+T细胞变化的临床意义。方法收集2017年3—8月重庆市第五人民医院就诊的120例肺结核患者基线及治疗6个月后的临床资料,包括外周血CD4^+T细胞计数和淋巴细胞计数等,并根据痰菌及治疗后病灶吸收情况进行分组比较。另选30名健康体验者作为对照组进行比较。结果基线时痰阳组及痰阴组CD4+T细胞分别为(373.83±145.39)和(496.24±226.44)个/mm^3均低于对照组,差异有统计意义(P<0.01)。治疗后肺部病灶吸收不明显者淋巴细胞及CD4^+T细胞分别为(1.93±0.77)×10^9/L和(436.96±119.55)个/mm^3,仍低于健康水平(P<0.01)。结论肺结核患者存在外周血CD4+T细胞减少,经抗结核治疗后,疗效明显患者外周血减少的CD4+T细胞部分可恢复,其水平与肺结核病情严重性相关。Objective To explore the clinical significance of the changes of CD4+T cell counts in patients with pulmonary tuberculosis after antitubercular treatment. Methods There were 120 patients with pulmonary tuberculosis in the Fifth People’s Hospital of Chongqing from March to August, 2017 enrolled. Clinical data including CD4+T cell counts and lymphocyte counts in peripheral blood at baseline and after 6-month treatment were collected. The patients were divided into different groups based on the bacteria detection results and the absorption of lesions after treatment. Thirty healthy individuals were enrolled as control group. Results At baseline, CD4+T cell counts in the positive and negative sputum bacteria groups were (373.83±145.39) and (496.24±226.44)/mm3, which were both lower than those in the healthy control group, and the differences were statistically significant (P<0.01). After treatment, the levels of lymphocytes and CD4+ T cells in the poor absorption group were (1.93±0.77)×109/L and (436.96±119.55)/mm3, which were significantly lower than those in the healthy control group (P<0.01). Conclusions Peripheral blood CD4+T cell counts decrease in patients with pulmonry tuberculosis. After antitubercular treatment, CD4+T cell counts can recover in the effective patients, its level is related to the severity of the disease.

关 键 词：结核 CD4+T细胞 病灶吸收 

分 类 号：R521[医药卫生—内科学]