严重细菌感染患者外周血DNT淋巴细胞检测及其临床价值  

Detection of peripheral blood double negative T lymphocytes and its clinical value in patients with severe bacterial infection

作　　者：曾文[1] 龙亚男 钱净[1] 唐树荣[1] 田敏 赵明洁 太继琼[1] 吕甜 胡大春[1] ZENG Wen;LONG Yanan;QIAN Jing;TANG Shurong;TIAN Min;ZHAO Mingjie;TAI Jiqiong;LYU Tian;HU Dachun(Department of Clinical Laboratory,Kunming Municipal No.1 People′s Hospital/Affiliated Ganmei Hospital of Kunming Medical University,Kunming,Yunnan 650011,China)

机构地区：[1]云南省昆明市第一人民医院/昆明医科大学附属甘美医院检验科

出　　处：《检验医学与临床》2019年第16期2339-2342,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨严重细菌感染患者外周血CD4^-CD8^-双阴性T淋巴细胞(DNT淋巴细胞)的表达水平及其在细菌感染中的作用。方法选取2014年1月至2017年3月该院血培养阳性且临床明确诊断为严重细菌感染的87例患者纳入研究组,其中40例血培养转阴时间≥7 d者为A组,47例转阴时间<7 d者为B组;选取30例该院健康体检者作为健康对照组。采用流式细胞术对3组人群外周血免疫细胞:CD3^+T淋巴细胞比例、CD4^+T淋巴细胞比例、CD8^+T淋巴细胞比例、自然杀伤(NK)细胞比例、B淋巴细胞比例、DNT淋巴细胞比例,以及CD4^+/CD8^+进行检测与对比分析。结果(1)A组和B组患者CD3^+T淋巴细胞比例、CD8^+T淋巴细胞比例显著低于健康对照组,CD4^+/CD8^+显著高于健康对照组,差异均有统计学意义(P<0.05);(2)A组患者的DNT淋巴细胞比例高于B组和健康对照组,差异有统计学意义(P<0.05);(3)A组B淋巴细胞比例显著高于B组和健康对照组,差异有统计学意义(P<0.05);(4)B组NK细胞比例高于A组和健康对照组,差异有统计学意义(P<0.05)。结论T淋巴细胞亚群、B淋巴细胞和NK细胞水平变化均影响严重细菌感染患者病原体清除效率,其中DNT淋巴细胞可能参与了对CD4^+T淋巴细胞免疫应答的抑制过程,不利于机体对病原体的清除。检测外周血DNT淋巴细胞对患者治疗方案的调整有一定的参考价值。Objective To investigate and analyze the expression level of CD4^-CD8^-double negative T lymphocytes(DNT lymphocytes)and its role in bacterial infection for the patients with serious bacterial infections.Methods Eighty-seven cases of serious bacterial infections by blood culture positive and clinical diagnosis in this hospital from January 2014 to March 2017 were chosen into the research group.Among them,40 cases with blood culture negative conversion≥7 d served as the group A and 47 cases with blood culture negative conversion<7 d served as the group B.Thirty individuals undergoing the physical examination in this hospital were selected as the control group.The peripheral blood immune cells were detected by flow cytometry,including the proportions of CD3^+T lymphocytes,CD4^+T lymphocytes,CD8^+T lymphocytes,NK lymophocytes,B lymphocytes,DNT lymphocytes,and CD4^+/CD8^+.Results(1)The proportions of CD3^+T lymphocytes and CD8^+T lymphocytes in the group A and B were significantly lower than those in the healthy control group.The CD4^+/CD8^+was significantly higher than that in the healthy control group,and the differences were statistically significant(P<0.05);(2)the proportion of DNT lymphocytes in the group A was higher than that in the group B and healthy control group,and the differences were statistically significant(P<0.05);(3)the proportion of B lymphocytes in the group A was significantly higher than that in the group B and healthy control group,and the difference was statistically significant(P<0.05);(4)the proportion of NK lymphocytes was the group B higher than group A and healthy control group,the differences were statistically significant(P<0.05).Conclusion The balance of T lymphocytes,and changes of B lymphocytes and NK lymphocytes affect the efficiency of pathogens clearing in the patients with severe bacterial infection,in which DNT lymphocytes may participate in the inhibiting effect on CD4^+T lymphocytes immune response and is not conducive to the body to clear the pathogens.Clinical detection of

关 键 词：细菌感染 CD4^-CD8^-双阴性T淋巴细胞 免疫应答 

分 类 号：R446.11[医药卫生—诊断学]