初治和复治肺结核患者外周血淋巴细胞亚群的变化及其临床意义

摘要

目的 比较初治肺结核与复治肺结核患者外周血淋巴细胞亚群比例的变化及其临床意义.方法 采用流式细胞仪抗体双标法测定外周血中淋巴细胞亚群的变化,并进行统计学分析.结果 与健康对照组相比,初治肺结核患者外周血中B淋巴细胞和CD4++CD+28/CD3+比例显著高于对照组,NK细胞水平显著低于对照组(P＜0.05);T淋巴细胞、CD4+T淋巴细胞、CD8+T淋巴细胞、CD4+/CD8+比值、CD8+CD+28/CD3+、CD8+CD-28/CD3+和CD4+CD-28/CD3+无明显变化(P＞0.05).与健康对照组相比,复治肺结核患者外周血中CD8+CD+28/CD3+、CD8+CD+28/CD3+和CD4+CD+28/CD3+比例显著高于对照组(P＜0.05、P＜0.01),而CD4+CD+28/CD3+显著低于对照组(P＜0.01);B淋巴细胞、T淋巴细胞、NK(Natural killer)细胞、CD4+T淋巴细胞、CD8+T淋巴细胞、CD4+/CD8+比值则无明显变化(P＞0.05).复治肺结核患者外周血中CD8+CD+28/CD3+和CD4+CD+28/CD3+比例显著低于初治肺结核组(P＜0.05、P＜0.01),而CD8+CD+28/CD+和CD4+CD+28/CD3+比例显著高于初治肺结核组(P＜0.05、P＜0.01).与无空洞的初治肺结核患者相比,有空洞的初治肺结核患者外周血中B3淋巴细胞明显降低(P＜0.05),与无空洞的复治肺结核患者相比,有空洞的复治肺结核患者外周血中CD4+CD+28/CD3+细胞明显降低(P＜0.05).结论 初治和复治肺结核患者体内存在不同程度的淋巴细胞亚群变化并,其中T淋巴细胞与NK细胞比例与肺结核的进展有一定的关联性.%Objective To investigate the changes and clinical significance of the frequencies of peripheral blood T-cell subsets from initial and retreated cases of tuberculosis. Methods The frequencies of peripheral blood T lymphocyte subsets were determined by flow cytometry, and then the correlation with clinical parameters was analyzed. Results The results showed that in the peripheral blood of initial treated pulmonary tuberculosis, the frequencies of B lymphocytes and CD4+CD28+population were both significantly increased while the frequency of NK cells decreased significantly compared with the control group. However, there was no significant difference between the new cases and the control group in the frequencies of T lymphocytes, CD4+T lymphocytes, CD8+T lymphocytes, CD8+CD28+, CD8+CD28-, CD4+CD28- populations, and the ratio of CD4+to CD8. Intriguingly, in the peripheral blood of the retreated cases, the frequencies of CD4+CD28+, CD4+CD28- and CD8+CD28- populations were significantly higher than those in the control group. However, there was no significant difference in B lymphocytes, T lymphocytes, NK cells, CD4+T lymphocytes, CD8+T lymphocytes, and the ratio of CD4+and CD8+. Moreover, it found that the frequencies of CD4+CD28+and CD8+CD28+in the peripheral blood of the retreated cases were significantly lower than those of the initial treated cases, while the frequencies of CD4+CD28- and CD8+CD28- were significantly higher. Additionally, it found that in initial treated cases, the frequency of B lymphocytes from pulmonary tuberculosis patients with cavity were significantly decreased compared with the patients without cavity, while the frequency of CD4+CD28- from the pulmonary tuberculosis patients with cavity were obviously decreased compared with the patients without cavity in retreated cases.Conclusion In conclusion, varying degrees of abnormalities of the lymphocyte subsets from initial and retreated cases of pulmonary tuberculosis are observed and can provide some valuable indexes for diagnosis of pulmonary tuberculosis.