目的：探讨结核患者外周血辅助性 T 细胞17（Th17细胞）及白细胞介素‐17（IL‐17）水平变化及意义。方法：以结核患者98例（初治58例，复治40例）、健康对照者98例为研究对象，抽取研究对象外周血并分离外周血单核细胞（PBMC）和血浆，采用流式细胞术（FCM）检测 PBMC中 Th17细胞的百分率，酶联免疫吸试验（ELISA）检测血浆中 IL‐17水平；用灭活的结核分枝杆菌菌株（H37Rv）分别刺激结核患者和健康对照者 PBMC ，ELISA 法检测其上清中 IL‐17水平。结果：与健康对照者比较，结核患者外周血Th17细胞比例[（5．2±1．8）％ vs（1．8±1．4）％，P＜0．05]及IL‐17水平[（68．22±10．31）vs（39．81±14．58）pg/ml ，P＜0．01]显著增高；与初治组比较，复治组 Th17细胞比例[（6．4±1．8）％ vs（3．8±1．3）％，P＜0．05]及 IL‐17水平[（85．46±9．13）vs （51．22±12．36）pg/ml ，P＜0．05]显著增高；结核患者血浆IL‐17水平与 Th17细胞的比例呈正相关（r＝0．912，P＜0．05）；H37RV 刺激结核病人和健康对照者 PBMC后上清中均有IL‐17的表达，且结核病人来源的表达水平更高。结论：结核患者外周血 Th17细胞比例及 IL‐17水平增高，T h17细胞和IL‐17在结核病的发生发展中发挥了重要作用。% Objective:To investigate the changes and clinical significance of Th17 cells and IL‐17 levels in tuberculosis (TB) patient's peripheral blood .Methods:The study involved 98 TB patients (58 initial treat‐ment patients ,40 re‐treatment patients) and 98 healthy controls .Peripheral blood mononuclear cell (PBMC) and plasma derived from their peripheral blood were tested .Flow cytometry was used to determine the per‐centage of Th17 cells in PBMC ,enzyme‐linked immunosorbent assay (ELISA ) was used to determine the levels of IL‐17 in plasma ;TB patients and healthy controls'PBMC were infected with heat‐inactivated myco‐bacterium tuberculosis (M .tb) H37Rv ,the levels of IL‐17 in supernatant of PBMCs were measured by ELISA .Results:To compare with the healthy controls ,the percentages of Th17 cells in TB patients'periph‐· 274 ·eral blood were significantly increased [(5 .2 ± 1 .8)% vs(1 .8 ± 1 .4)% ,P<0 .05];the levels of IL‐17 in TB patient's plasma were significantly higher than that in healthy controls [(68 .22 ± 10 .31)vs(39 .81 ± 14 .58) ng/L ,P<0 .01] .In addition ,compared with initial treatment patients ,the percentages of Th17 cells [(6 .4 ± 1 .8)% vs(3 .8 ± 1 .3)% , P<0 .05] and IL‐17 levels [(85 .46 ± 9 .13)vs (51 .22 ± 12 .36)ng/L , P<0 .05] in re‐treatment patients were significantly increased .The levels of IL‐17 and the percentages of Th17 cells were positively correlated(r=0 .912 ,P<0 .05);IL‐17 in the supernatant of TB patients and healthy controls'PBMC infected with M .tb H37Rv were expressed ,relatively high levels were from TB patients'supernatant . Conclusion :T he percentages of T h17 cells and the levels of IL‐17 in TB patient's peripheral blood are signifi‐cantly increased compared with healthy controls ,Th17 cells and IL‐17 play important roles in the initiation and progression of TB .
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