结核性胸液淋巴细胞行为的单细胞定量研究

Monocellular quantitative analysis on cellular behavior characteristics of lymphocyte in tuberculous effusion

目的 :为探讨结核性胸液淋巴细胞行为的特点及在病理过程中的意义。方法 :采用单细胞微管吸吮技术 ,分别检测正常人外周血淋巴细胞、结核性胸膜炎患者外周血淋巴细胞、胸液中淋巴细胞与肺血管内皮细胞的粘附特点。结果 :结核性胸膜炎患者外周血淋巴细胞的粘附性 (2 .83± 0 .4 3Pa)较正常人 (1.2 1± 0 .2 5Pa)明显增强 ,但结核性胸液中淋巴细胞的粘附性(1.6 7± 0 .39Pa)却与正常人无明显差别。结论 :结核性胸膜炎患者外周血淋巴细胞处刺激激活状态 ,其粘附性升高有利于贴壁向血管外游走进而向胸膜腔渗出。结核性胸液中淋巴细胞粘附性呈现正常水平可能系由于胸液中高浓度游离型上皮来源的粘附分子将其表面表达的粘附分子饱和的缘故。此现象提示胸液中的淋巴细胞 ,不易回吸收 ,其去除多以凋亡方式 ,最好籍助外力清除 (胸穿抽液 )。

Objective:To evaluate the cellular behavior characteristics of the lymphocyte in tuberculous pleural effusion.Methods:Micromanipulation technique was used to detect the adhesive ability of normal human peripheral blood lymphocytes,the peripheral blood lymphocytes and the lymphocytes in pleural effusion from patients with tuberculous pleurisy to pulmonary endothelial cells respectively.Results:The adhesive force (2.83±0.43,Pa) of peripheral blood lymphocytes in patients with tuberculous pleurisy was significantly higher than that in normal person(1.21±0.25,Pa),but there was no obvious increase of adhesive ability(1.67±0.39,Pa) in the lymphoeytes in pleural effusion.Conclusion:The peripheral blood lymphocytes from patients with tuberculous pleurisy is in the active state.Its high adhesive ability is helpful for its keeping close to wall,travelling through wall and exuding into pleural cavity.The normal level adhesive ability of lymphocytes may be owing to the high concentration of dissociating adhesive molecules in pleural effusion from epithelium which saturate the adhesive molecule on the surface of lymphocytes in tuberculous effusion.This implys that the lymphocytes in tuberculous pleural effusion can not be reclaimed easily.They are often wiped off by apoptosis or by thoracocentesis.