RPR持续阳性梅毒患者的传染性与细胞免疫的相关性研究

Correlation between the peripheral blood lymphocyte subsets and infectivity of syphilis patients with persisting positive RPR

目的:检测RPR持续阳性经治梅毒患者外周血淋巴细胞亚群,探讨其传染性与细胞免疫的相关性。方法:应用流式细胞仪检测RPR持续阳性梅毒患者中38例IgM阳性和32例IgM阴性的患者外周血T细胞亚群及NK细胞,并以30例健康人作为对照组。结果:IgM阳性组外周血CD3、CD4和CD8细胞均高于对照组(P<0.05),而NK细胞低于对照组(P<0.001);IgM阴性组外周血CD3、CD4细胞低于对照组(P<0.05),而CD8细胞及NK细胞均高于对照组(P<0.05);两组之间外周血淋巴细胞亚群的检测结果相比,IgM阳性组CD3、CD4细胞高于IgM阴性组(P<0.001),NK细胞低于IgM阴性组(P<0.001),而CD8细胞相比差异无显著性(P>0.05)。结论:RPR持续阳性梅毒患者存在明显的细胞免疫不平衡和免疫抑制;NK细胞显著降低可能是RPR持续阳性且具传染性的主要原因。

Objective: To detect the profiles of lymphocyte subsets of peripheral blood in syphilis patients with persisting positive RPR after treatment and to explore the correlation of the infectivity with the cellular immunity among the patients. Methods: T-lymphocyte subsets and NK cells in peripheral blood were measured with flow cytomery among 38 syphilis patients with positive IgM and 32 syphilis patients with negative IgM. The RPR tests of all these patients were persisting positive after treatment. The normal subjects were taken as controls. Results: The levels of CD3, CD4 and CD8 T cells of peripheral blood in syphilis patients with positive IgM were higher than those in the controls (P<0.05), but the NK cells in the patients were lower than that in the controls (P<0.001). The CD3 and CD4 of the peripheral blood in syphilis patients with negative IgM were lower than that in the controls (P<0.05), and CD8 and NK cells were higher than that in the controls (P<0.05). The levels of CD3 and CD4 of peripheral blood in syphilis patients with positive IgM were higher than that in syphilis patients with negative IgM (P<0.05) and the NK cells in syphilis patients with positive IgM were lower than that in syphilis patients with negative IgM (P<0.001), but CD8 lymphocyte did not show significant difference (P>0.05). Conclusion: The results suggest that there are prominent imbalance and suppression of cellular immunity in patients with persisting positive RPR, and the significantly low NK cells may be the major reason for the infectivity of syphilis after treatment.