新冠肺炎合并肺结核患者外周血淋巴细胞亚群变化的初步观察  

Preliminary observation on changes of lymphocyte subsets in peripheral blood of patients with COVID-19 complicated with tuberculosis

作　　者：王帅[1] 董维浩 王素平[1] 郭勇[2] 徐晟伟[2] WANG Shuai;DONG Weihao;WANG Suping;GUO Yong;XU Shengwei(Department of Neurorehabilitation,Qingdao Third People's Hospital,Qingdao 266041,Shandong,China;Department of Critical Care Medicine,Qingdao Third People's Hospital,Qingdao 266041,Shandong,China)

机构地区：[1]青岛市第三人民医院神经康复科,山东青岛266041 [2]青岛市第三人民医院重症医学科,山东青岛266041

出　　处：《暨南大学学报（自然科学与医学版）》2022年第6期653-657,665,共6页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：青岛市医药科研指导计划项目(2020-WJZD089)。

摘　　要：目的:探讨新型冠状病毒肺炎合并肺结核患者外周血淋巴细胞亚群的变化。方法:采用流式细胞分析仪检测新冠肺炎合并肺结核患者和同期感染的无合并肺结核的新冠肺炎患者外周血淋巴细胞亚群,分析两组患者辅助性T细胞数(CD3^(+)CD4^(+))、辅助性T细胞比率、CD4^(+)/CD8^(+)T细胞比值、CD3^(+)CD4^(+)CD8^(+)T细胞数的差异。同时比较两组患者病毒转阴时间的差异。结果:(1)与对照组比较,新冠肺炎合并肺结核患者组2例患者CD3^(+)CD4^(+)T细胞数量下降,2例患者正常范围;对照组中2例患者CD3^(+)CD4^(+)T细胞数量增高,1例患者正常范围,1例患者CD3^(+)CD4^(+)T细胞数量下降。新冠肺炎合并肺结核患者组1例患者CD4^(+)/CD8^(+)T细胞比值下降,3例患者正常范围;对照组中1例患者CD4^(+)/CD8^(+)T细胞比值增高,3例患者正常范围。(2)与对照组比较,新冠肺炎合并肺结核患者组核酸检测转阴天数最短16d,最长24d,同期感染的无合并肺结核的新冠肺炎患者核酸检测转阴天数最短8d,最长18d。结论:新型冠状病毒和肺结核均可能会干扰人体的免疫系统,引起机体T淋巴细胞亚群的改变。新冠肺炎合并肺结核可能会增加患者新冠病毒转阴的时间。今后有待扩大样本量,深度分析新冠肺炎合并肺结核患者体内免疫指标的变化。Objective:To investigate the changes of lymphocyte subsets in peripheral blood of patients with COVID-19 complicated with pulmonary tuberculosis.Methods:Flow cytometry was used to analyze and detect the differences in peripheral blood lymphocyte subsets,the number of helper T cells(CD3^(+)CD4^(+)),the ratio of helper T cells,the ratio of CD4^(+)/CD8^(+)T cells,and the number of CD3^(+)CD4^(+)CD8^(+)T cells in patients with tuberculosis complicated with COVID-19,which was compared to the COVID-19 patients without tuberculosis who were infected during the same period.Meanwhile,the difference of virus turning negative time between the two groups was compared.Results:(1)Compared with the control group,CD3^(+)CD4^(+)T cells decreased significantly in the two patients of COVID-19 complicated with pulmonary tuberculosis group,and the remaining two patients were in normal range,in the control group who COVID-19 patients without tuberculosis,the number of CD3^(+)CD4^(+)T cells was significantly increased in two patients,the number of remaining one patient was normal range,and the other patient decreased.The CD4^(+)/CD8^(+)T cells ratio decreased in one patient with COVID-19 combined with tuberculosis,and was within the normal range in three patients,in the control group,one patient had an elevated CD4^(+)/CD8^(+)T cell ratio,while the other three patients were normal.(2)Compared with the control group,the time of nucleic acid test turning negative for COVID-19 patients complicated with tuberculosis were 16 days at the shortest and 24 days at the longest,while the time of nucleic acid test turning negative for COVID-19 patients without tuberculosis during the same period were 8 days at the shortest and 18 days at the longest.Conclusion:Both COVID-19 and tuberculosis interfere with the immune system,causing changes in the T lymphocytes subsets.The combination of COVID-19 and tuberculosis may increase the time for COVID-19 patients to turn negative.It is still necessary to expand the sample number to further clarify the chan

关 键 词：新型冠状病毒肺炎 肺结核 淋巴细胞亚群 

分 类 号：R184[医药卫生—流行病学] R511[医药卫生—公共卫生与预防医学]