肺结核患者支气管肺泡灌洗液中T细胞亚群的检测

摘要

目的探讨肺结核患者支气管肺泡灌洗液(Bronchoalveolar Lavage Fluid,BALF)中T细胞亚群及免疫状态的变化.方法予54例肺结核患者留取痰液并行支气管肺泡灌洗术获得BALF,对痰和BALF结核菌涂片进行抗酸染色镜检,用碱性磷酸酶-抗碱性磷酸酶(APAAP)桥联酶标法测定54例肺结核患者与30例对照组BALF中T淋巴细胞亚群.结果 BALF细菌学检查阳性率51.85%,明显高于痰检24.07%(P<0.05)；T淋巴细胞亚群,肺结核组较对照组,CD3降低, CD4降低,CD8升高,CD4/CD8降低,其差异在统计学上有意义(P<0.05).结论 BALF细菌学检查对肺结核的快速诊断具有重要的临床价值,T淋巴细胞亚群可作为肺结核患者免疫状态的指标,并可指导临床治疗.%　　Objective To study the changes of T lymphocyte subsets in BALF (Bronchoalveolar Lavage Fluid) and im-mune status in patients with pulmonary tuberculosis. Methods There were 54 tuberculosis patients collected sputum and un-derwent bronchial alveolar lavage to get BALF. All samples of BALF and sputum were tested for MTB(Mycobacetium Tuberculo-sis) by microscope examination using acid fast staining. T lymphocyte subsets were tested by alkaline phosphatase-anti-alkaline phosphatase (APAAP) bridging enzyme linked immunosorbent assay between 54 tuberculosis patients and 30 control group. Results The positive rate of BALF (51.85%) was significantly higher than that of sputum (24.07%)P<0.05. CD3,CD4,CD4/CD8,in tuberculosis patients were significantly lower than those in control group.However,the values of CD8 were significantly higher than those in control group.There was statistically significant difference (P<0.05). Conclusion Acid fast staining for MTB using BALF is of significantly clinical value for rapid diagnosis of pulmonary tuberculosis. T lymphocyte subsets can be used as the index of immune status in patients with pulmonary tuberculosis, and to guide clinical therapy.