肺结核患者T淋巴细胞亚群及血清CRP、TNF-α、INF-γ的检测意义  

Significance of detecting T lymphocyte subsets,serum CRP,TNF-α,and INF-γin pulmonary tuberculosis patients

作　　者：韩永峰 张长征 路晓娜 于秀杰 董文文 王继绪 HAN Yongfeng;ZHANG Changzheng;LU Xiaona;YU Xiujie;DONG Wenwen;WANG Jixu(Infection Department of Jinan People′s Hospital,Jinan,Shandong 271100,China)

机构地区：[1]济南市人民医院感染科,山东济南271100 [2]淄博市中医医院门诊部 [3]淄博市中医医院中医科 [4]聊城市东昌府区妇幼保健院检验科

出　　处：《医学动物防制》2024年第11期1132-1135,1140,共5页Journal of Medical Pest Control

基　　金：山东省自然科学基金(2020887)。

摘　　要：目的研究T淋巴细胞亚群及血清C反应蛋白(C-reactive protein,CRP)等指标与肺结核患者病情严重程度、预后的关系。方法选取济南市某医院感染科2020年6月—2023年6月收治的150例肺结核患者,纳入肺结核组;选择同期入院体检的150例健康人,纳入对照组。测量两组的T淋巴细胞亚群及血清CRP等指标水平。根据病情严重程度和预后情况对肺结核组进一步分组,观察各项指标差异情况,进行活动性肺结核患者预后不良的危险因素分析。结果肺结核组CD4^(+)T淋巴细胞水平显著低于对照组,CD8^(+)T淋巴细胞及血清CRP等指标水平高于对照组,差异有统计学意义(t=18.799、19.404、60.245、55.184、58.785,P<0.05);活动性肺结核患者与非活动性肺结核患者各项指标水平差异有统计学意义(t=15.699、12.851、36.727、36.485、34.652,P<0.05);重症患者、预后不良患者与轻症患者、预后良好患者各项指标水平差异有统计学意义(t=15.146、10.048、20.590、25.181、15.377、11.864、11.556、20.874、26.267、13.932,P<0.05);CD4^(+)T淋巴细胞为活动性肺结核患者预后不良的保护因素(OR=0.716,P<0.05);CD8^(+)T淋巴细胞、CRP等指标为活动性肺结核患者预后不良的独立危险因素(OR=1.485、1.619、1.593、1.499,P<0.05)。结论肺结核患者CD4^(+)T淋巴细胞水平较普通人群更低,CD8^(+)T淋巴细胞和CRP等指标血清水平较普通人群更高,与肺结核活动性及患者病情严重程度关联密切,是肺结核患者预后的影响因素。Objective To investigate the relationship between T lymphocyte subsets,serum C-reactive protein(CRP)and other tests,between the severity and prognosis of disease condition of pulmonary tuberculosis patients.Methods A total of 150 pulmonary tuberculosis patients admitted to the infectious disease department of a hospital in Jinan from June 2020 to June 2023 were enrolled in the pulmonary tuberculosis group,while 150 healthy individuals who underwent physical examination during the same period were included in the control group.The levels of T lymphocyte subsets,serum CRP and other tests were measured in both groups.The pulmonary tuberculosis group was further grouping based on different disease condition of disease severities and prognoses to observe the differences in various indicators and to analyze the risk factors for poor prognosis in patients with active pulmonary tuberculosis.Results The level of CD4^(+)T lymphocytes in the pulmonary tuberculosis group was significantly lower than that in the control group,while the levels of CD8^(+)T lymphocytes,serum CRP and other tests were higher than that in the control group,with statistically significant differences(t=18.799,19.404,60.245,55.184,58.785,P<0.05).There were statistically significant differences in the levels of various indicators between patients with active and inactive pulmonary tuberculosis(t=15.699,12.851,36.727,36.485,34.652,P<0.05).Similarly,statistically significant differences were found in the levels of various indicators between patients with severe disease,poor prognosis,mild disease,and good prognosis(t=15.146,10.048,20.590,25.181,15.377,11.864,11.556,20.874,26.267,13.932,P<0.05).CD4^(+)T lymphocytes were identified as a protective factor for poor prognosis in patients with active pulmonary tuberculosis(OR=0.716,P<0.05),while CD8^(+)T lymphocytes,CRP and other tests were independent risk factors(OR=1.485,1.619,1.593,1.499,P<0.05).Conclusion The level of CD4^(+)T lymphocytes is lower in pulmonary tuberculosis patients compared to healthy ind

关 键 词：T淋巴细胞 肺结核 病情 预后 Γ-干扰素 C反应蛋白 

分 类 号：R563.9[医药卫生—呼吸系统] R521[医药卫生—内科学]