肺结核患者全血细胞减少的发病机理探讨

Pancytopenia in patients with pulmonary tuberculosis

目的探讨肺结核合并全血细胞减少的可能发病机理。方法采用间接免疫荧光法检测23例初诊肺结核合并全血细胞减少患者治疗前后T细胞亚群(CD3、CD4、CD8、CD4/CD8),双抗体夹心ELISA法检测患者治疗前后血清IL-2、IFN-γ、IL-4和IL-10,全自动生化仪免疫透射比浊法定量检测患者治疗前后血清免疫球蛋白(IgG、IgA和IgM)。同时,同期检测20例健康者的上述指标作为对照。结果患者治疗前CD4/CD8倒置,Th1类细胞因子(IL-2、IFN-γ)呈低水平,Th2类细胞因子(IL-4和IL-10)明显增高(与正常对照比较P<0.01);血清免疫球蛋白明显增高(与正常对照比较均P<0.01),且以IgG增高为主。结论肺结核合并全血细胞减少患者其免疫异常导致自身抗体大量产生是主要原因之一。

Objective： To explore the probable mechanism of pancytopenia in patients with pulmonary tuberculosis. Methods The T- cell subsets （CD3 ,CD4 ,CD8 ） were measured with indirect immunofluorescence technique in 23 patients with pulmonary tuberculosis. The serum levels of IL -2, IFN - 7, IL -4 and IL - 10 were measured with enzyme immuno -sorbent assay （ELISA）, the serum immunoglobulin （IgC, IgA, IgM） with immune transmission turbidimetry. Meanwhile, we measured these indexes for the controlling donors. Results： The CD4/CD8 ratio were inversus in patients. There were a lower level of IL - 2 and IFN - 7, and a significantly elevated level of IL - 4 and IL - 10. The immunoglobulin levels were higher than those in the controlling donors. Conclusion ： We think that the abnormal immunity is a significant cause ofpancytopenia in patients with pulmonary tuberculosis.