TH1、TH17及其细胞因子与结核性胸膜炎胸膜粘连的相关性  

Correlationship between TH1,TH17,its cytokines and pleural adhesions of tuberculous pleuris

作　　者：李炜霞 赵芝焕[1] 张家强[1] 舒敬奎[1] 吴锦涛 刘凌[1] LI Weix-ia;ZHAO Zhihuan;ZHANG Jiaqiang;SHU Jingkui;WU Jintao;LIU Ling(The Second Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院呼吸与危重症医学二科,昆明650032

出　　处：《实用医学杂志》2020年第15期2099-2103,共5页The Journal of Practical Medicine

基　　金：云南省卫生科技计划项目(编号:2014NS166)。

摘　　要：目的本研究探讨结核性胸膜炎(tuberculous pleurisy,TP)患者TH1和TH17淋巴细胞比例、相关细胞因子与胸膜粘连以及粘连程度的相关性。方法收集2017年6月至2019年6月内科胸腔镜检查确诊为TP的89例住院患者;采集患者外周血及胸腔积液并收集相关临床参数,分别应用流式细胞技术、酶联免疫吸附(ELISA)方法测定外周血和胸腔积液中CD4+T淋巴细胞、TH1、TH17细胞比例和IFN-γ、IL-17的水平。结果在内科胸腔镜直视下入组的89例TP患者中无粘连组11例、轻度粘连组49例、重度粘连组29例。3组患者外周血中的TH1、TH17淋巴细胞比例及IFN-γ、IL-17的水平均小于胸水,差异有统计学意义(P <0.05);而且,入组受试者胸水中TH1细胞比例、TH17细胞比例、TH17比TH1的值、IL-17以及IFN-γ水平与0-4级粘连分级之间呈正相关(P <0.05)。结论 TP患者胸水中TH1、TH17细胞比例以及IFN-γ、IL-17的水平对于评价TP患者是否存在胸膜粘连有重要意义,与胸膜粘连程度呈正相关关系;特别是在疾病早期上述因子水平越高,发生胸膜粘连的风险越高。Objective To investigate the correlationship between the proportion of lymphocytes,related cytokines of TH1 and TH17 and the degree of pleural adhesion in patients with tuberculous pleurisy(TP).Methods A total of 89 inpatients who diagnosed as TP by medical thoracoscopy were collected from June 2017 to June 2019-Samples of peripheral blood and pleural effusion and relevant clinical parameters of all the patients were collected;Flow cytometry was used to determine the ratio of CD4^+ T lymphocytes,TH1,and TH17 cells in peripheral blood and pleural effusion,and the levels of IFN-γ and IL-17 were measured by enzyme-linked immunosorbent assay(ELISA).Results Of all the 89 patients with TP enrolled,11 patients were in the non-pleural adhesion group,49 patients were in the mild pleural adhesion group,and 29 patients were in the severe pleural adhesion group.In addition,the proportion of TH1 cells,TH17 cells,the ratio of TH17 to TH1,IL-17 and IFN-γ levels in the pleural effusion of the subjects were positively correlated with grades 0 to 4(P <0.05).Conclusion The proportion of TH1,TH17 cells and the levels of IFN-γ and IL-17 in the pleural effusion of TP patients are of great significance to evaluate the presence of pleural adhesion in TP patients,and have a positive correlation with the degree of pleural adhesion;Espacially in the early stages of TP,the higher the levels of these factors,the higher the risk of pleural adhesions.

关 键 词：结核性胸膜炎 T淋巴细胞 细胞因子 胸膜粘连 

分 类 号：R521.7[医药卫生—内科学]