广泛耐药性肺结核外周血T细胞亚群结构及临床特点分析  

Structure and clinical characteristics of peripheral blood T lymphocyte subsets in extensively drug-resistant pulmonary tuberculosis

作　　者：林丽红[1] 卢滔[1] 方英[1] LIN Li-hong;LU Tao;FANG Ying(Qiizhou People's Hospital,Quzhou,Zhejiang 324000,China)

机构地区：[1]衢州市人民医院,浙江衢州324000

出　　处：《中国卫生检验杂志》2020年第4期454-456,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的分析耐多药物(MDR)和广泛耐药(XDR)肺结核患者外周血T细胞亚群结构和临床特点比较。方法选取2017年10月-2018年10月在本院就诊的120例患者作为研究对象,其中MDR患者60例,XDR患者60例,采用流式细胞仪分析患者T细胞亚群结构,对比2组患者药敏结果、T细胞亚群结构、临床资料的特点。结果 XDR组患者慢性阻塞性肺疾病、糖尿病、慢性乙型肝炎的合并率明显高于MDR组患者,复治率明显更高,且XDR-TB组患者并发支气管结核、结核性胸膜炎、支气管扩张、呼吸衰竭的发病率均明显高于对照组患者。XDR组患者Treg细胞水平,Treg/Th17细胞水平,均明显低于MDR组患者,差异均有统计学意义(P <0. 05),而Th17细胞水平,明显高于MDR组患者。XDR-TB组患者对链霉素、乙胺丁醇、氧氟沙星、乙硫异烟胺、卡那霉素、卷曲霉素耐药率明显高于对照组。结论广泛耐药肺结核外周血T细胞结构紊乱,值得临床重点关注。Objective To analyze the structure and clinical characteristics of T lymphocyte subsets in peripheral blood of patients with multidrug resistant( MDR) and extensively drug resistant( XDR) pulmonary tuberculosis. Methods A total of120 patients with MDR and XDR from October 2017 to October 2018 were selected as the study subjects. Flow cytometry was used to analyze the T cell subsets of the patients. The drug sensitivity,T cell subsets and clinical data of the two groups were compared. Results The combined rate of chronic obstructive pulmonary disease,diabetes mellitus and hepatitis B in XDR group was significantly higher than that in MDR group. The incidence of bronchial tuberculosis,tuberculosis pleurisy,bronchiectasis and respiratory failure in XDR-TB group was significantly higher than that in control group. Treg cell level in XDR group and Treg/Th17 cell level were were significantly lower than those in MDR group,with the differences statistically significant( P < 0. 05);while Th17 cell level was significantly higher than that in MDR group. The resistance rates of streptomycin,ethambutol,ofloxacin,ethionicotinamide,kanamycin and capreomycin in XDR-TB group were significantly higher than those in control group. Conclusion The disorder of T cell structure in peripheral blood of extensively drug-resistant pulmonary tuberculosis deserves clinical attention.

关 键 词：肺结核 T细胞亚群 多重耐药菌 临床特点 

分 类 号：R336.5[医药卫生—人体生理学]