结核分枝杆菌T细胞斑点试验、肺泡灌洗液T细胞亚群检测在肺结节病和肺结核鉴别诊断作用  

Differential diagnosis of pulmonary sarcoidosis and pulmonary tuberculosis by T cell spot test and T cell subsets of alveolar lavage fluid

作　　者：邓群[1] 刘建锋[1] 姚佳惠子 黄健[1] DENG Qun;LIU Jian-feng;YAO Jia-hui-zi;HUANG Jian(Department of Tuberculosis,Jiangxi Chest Hospital,Jiangxi Province,Nanchang 330006,China)

机构地区：[1]江西省胸科医院结核科,江西南昌330006

出　　处：《中国当代医药》2021年第30期154-156,共3页China Modern Medicine

基　　金：江西省卫生厅科技计划项目(20165512)。

摘　　要：目的研究结核分枝杆菌T细胞斑点试验、肺泡灌洗液T细胞亚群检测在肺结节病和肺结核中的鉴别诊断作用。方法选取2019年3月至2020年3月江西省胸科医院结核科收治的60例肺部疾病患者作为研究对象,根据疾病的类型不同,将其分为观察组(肺结节病,30例)和对照组(肺结核病,30例)。对患者实施结核分枝杆菌T细胞斑点试验、肺泡灌洗液T细胞亚群检测,比较两组的阳性率及CD4^(+)/CD8^(+)、CD8^(+)、CD4^(+)、CD3^(+)水平。结果观察组患者结核分枝杆菌T细胞斑点试验中,结核感染T细胞斑点试验阳性患者2例,阳性率为6.67%;对照组患者结核分枝杆菌T细胞斑点试验中,结核感染T细胞斑点试验阳性患者11例,阳性率为36.67%。观察组的结核分枝杆菌T细胞斑点试验阳性率低于对照组,差异有统计学意义(P<0.05)。观察组患者的CD4^(+)/CD8^(+)(1.31±0.07)、CD8^(+)[(27.41±6.71)%]低于对照组[(2.91±0.15)、(32.11±7.61)%],差异有统计学意义(P<0.05),CD4^(+)[(63.51±7.26)%]、CD3^(+)[(88.79±5.31)%]高于对照组[(41.27±3.1)、(76.19±6.21)%],差异有统计学意义(P<0.05)。结论在肺结节病和肺结核诊断过程中,采用结核分枝杆菌T细胞斑点试验、肺泡灌洗液T细胞亚群检测,能对上述疾病有效鉴别。Objective To study the differential diagnosis of pulmonary sarcoidosis and pulmonary tuberculosis by T cell spot test and T cell subsets of alveolar lavage fluid.Methods A total of 60 patients with pulmonary diseases admitted to the Department of Tuberculosis,Jiangxi Chest Hospital from March 2019 to March 2020 were selected as the research objects.According to the different types of disease,they were divided into observation group(pulmonary sarcoidosis,30 cases)and control group(pulmonary tuberculosis,30 cases).Mycobacterium tuberculosis T cell spot test and alveolar lavage fluid T-cell subsets were performed to compare the positive rate and levels of CD4^(+)/CD8^(+),CD8^(+),CD4^(+)and CD3^(+)between the two groups.Results In the mycobacterium tuberculosis T-cell spot test in the observation group,there were 2 tuberculosis infection T-cell spot test positive patients,the positive rate was 6.67%.In the mycobacterium tuberculosis T-cell spot test of the control group,11 patients with tuberculosis infection t-cell spot test were positive,the positive rate was 36.67%.The positive rate of mycobacterium tuberculosis T-cell spot test in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).CD4^(+)/CD8^(+)(1.31±0.07)and CD8^(+)([27.41±6.71]%)in observation group were lower than those in control group([2.91±0.15]and[32.11±7.61]%),and the differences were statistically significant(P<0.05).CD4^(+)([63.51±7.26]%)and CD3^(+)([88.79±5.31]%)were higher than those in the control group([41.27±3.1],[76.19±6.21]%),and the differences were statistically significant(P<0.05).Conclusion In the diagnosis of pulmonary sarcoidosis and pulmonary tuberculosis,mycobacterium tuberculosis T-cell spot test and alveolar lavage fluid T-cell subgroup detection can be used to identify these diseases effectively.

关 键 词：结核分枝杆菌T细胞斑点试验 肺泡灌洗液T细胞亚群 肺结节病 肺结核 

分 类 号：R521[医药卫生—内科学]