儿童肺结核患者支气管肺泡灌洗液免疫细胞检测与分析  

Detection and analysis of immune cells in bronchoalveolar lavage fluid of child patients with pulmonary tuberculosis

作　　者：李金沛 叶涛生[1] 徐宇翔 曾旋 刘志超[2] 杨倩婷[3] Li Jinpei;Ye Taosheng;Xu Yuxiang;Zeng Xuan;Liu Zhichao;Yang Qianting(Department of Respiratory Endoscopy,The Third People's Hospital of Shenzhen,Guangdong Shenzhen 518112,China;Department of Pulmonary Medicine&Tuberculosis,The Third People's Hospital of Shenzhen,Guangdong Shenzhen 518112,China;Institute for Hepatology,National Clinical Research Center for Infectious Disease,Shenzhen Third People's Hospital,Guangdong Shenzhen 518112,China)

机构地区：[1]深圳市第三人民医院呼吸内镜室,广东深圳518112 [2]深圳市第三人民医院肺病三科,广东深圳518112 [3]深圳市第三人民医院肝病研究所,国家感染性疾病临床医学研究中心,广东深圳518112

出　　处：《新发传染病电子杂志》2023年第1期14-18,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：国家自然面上项目(82172286);深圳市科技计划项目(JCYJ20210324131603008)。

摘　　要：目的采用流式细胞仪检测肺结核患者支气管肺泡灌洗液淋巴细胞亚群,探讨肺结核患者支气管肺泡灌洗液淋巴细胞免疫功能状态的变化。方法选取19例儿童肺结核患者作为观察组,根据痰涂片结果分为菌阳组(11例)和菌阴组(8例)。同期选取就诊的21例成人肺结核患者作为对照组。通过流式细胞术对其进行检测,检测两组研究对象的支气管肺泡灌洗液T淋巴细胞、CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、单核细胞和B淋巴细胞比例的变化,并比较其差异性。结果儿童肺结核患者的支气管肺泡灌洗液中各免疫细胞的比例分别为:T淋巴细胞(54.57±5.28)%、CD4^(+)T淋巴细胞(66.14±4.08)%、CD8^(+)T淋巴细胞(33.80±4.07)%和B淋巴细胞(13.54±2.53)%与成人肺结核患者的T淋巴细胞(53.30±4.76)%、CD4^(+)T淋巴细胞(65.45±3.49)%、CD8^(+)T淋巴细胞(34.55±3.49)%和B淋巴细胞(14.70±2.83)%比较,两组差异均无统计学意义(P>0.05)。两组肺结核患者的CD4^(+)/CD8^(+)T淋巴细胞比例均无统计学差异(P>0.05)。儿童肺结核患者的单核细胞(16.00±3.20)%与成人肺结核患者(9.25±1.17)%比较,显著性增高,两者差异有统计学意义(P<0.05)。菌阳组支气管肺泡灌洗液中CD4^(+)T淋巴细胞(65.64±5.41)%、CD8^(+)T淋巴细胞(34.36±5.41)%和单核细胞(19.15±5.18)%与菌阴儿童结核患者CD4^(+)T淋巴细胞(66.84±6.65)%、CD8^(+)T淋巴细胞(33.03±6.58)%和单核细胞(11.75±1.75)%比较,差异均无统计学意义(P>0.05)。但菌阳组T淋巴细胞(45.06±6.38)%和B淋巴细胞(9.30±2.60)%显著低于菌阴组[分别为(67.64±6.93)%和(21.48±4.17)%],差异有统计学意义(P<0.05)。结论儿童肺结核患者的单核细胞高于成人肺结核患者;痰涂片细菌阳性的儿童结核患者B淋巴细胞的比例显著低于痰涂片细菌阴性患者。提示在活动性儿童结核患者的免疫功能有所下降,为了解肺结核的发病机制及为临床免疫治疗提供一定的理论�Objective To investigate the changes of lymphocyte immune function of pulmonary alveolar lavage fluid(BALF)in patients with pulmonary tuberculosis by flow cytometry.Method 19pediatric tuberculosis patients were enrolled,according to sputum smear results,they were divided into bacteria positive group(11 cases)and bacteria negative group(8 cases).21 adult tuberculosis patients were selected as the control group.Flow cytometry was used to detect the changes in the proportion of lymphocytes,CD4^(+)T cells,CD8^(+)T cells,monocytes and B lymphocytes in Balf of the two groups,and the differences were compared.Result The proportion of immune cells in Balf of children with tuberculosis was as follow:The proportion of T lymphocytes was(54.57±5.28)%,CD4^(+)T cells(66.14±4.08)%,CD8^(+)T cells(33.80±4.07)%and B cells(13.54±2.53)%pediatric tuberculosis patients.The proportion of T lymphocytes was(53.30±4.76)%,CD4^(+)T cells(65.45±3.49)%,CD8^(+)T cells(34.55±3.49)%and B cells(14.70±2.83)%in adult pulmonary tuberculosis patients.There was no statistical significance between the two groups(P>0.05).There was no difference in the ratio of CD4^(+)/CD8^(+)T cells between two groups(P>0.05).The monocytes of children tuberculosis patients(16.00±3.20)%were significantly higher than those of adult tuberculosis patients(9.25±1.17),and the difference was statistically significant(P<0.05).The proportion of CD4^(+)T lymphocyte was(65.64±5.41)%,CD8^(+)T lymphocyte(34.36±5.41)%and monocyte(19.15±5.18)%in the Balf of the positive of bacteriology subgroup of pediatric tuberculosis patients.The proportion of CD4^(+)T lymphocyte was(66.84±6.65)%,CD8^(+)T lymphocyte(33.03±6.58)%and monocyte(11.75±1.75)%in the negative of bacteriology subgroup of pediatric tuberculosis patients.There was no statistical significance(P>0.05).However,The proportion of T lymphocyte was(45.06±6.38)%and B cells(9.30±2.60)%in positive of bacteriology subgroup were significantly lower than those in the negative group[(67.64±6.93)%and(21.48±4.17)%],respec

关 键 词：肺结核 儿童结核 支气管肺泡灌洗液 细胞免疫 免疫细胞 

分 类 号：R529.9[医药卫生—内科学] R446.63[医药卫生—临床医学]