肺结核病患者外周血前炎性因子及细胞亚群凋亡的研究

Inflammatory Cytokine and T-cell Apoptosis in Patients with Tuberculosis

目的探讨前炎性因子及CD4+T淋巴细胞凋亡在结核病免疫病理过程中的作用及临床意义。方法对45例肺结核患者采用免疫酶联吸附法检测血清中的TNF-α及IL-10水平,分离外周血单核细胞标记后用流式细胞仪测定CD4+T淋巴细胞凋亡率,并进行相关性分析。结果肺结核患者血清中的TNF-α及IL-10水平明显高于健康对照组(P<0.05),其外周CD4+T淋巴细胞凋亡率明显高于健康对照组(P<0.05);涂阳组外周血CD4+T淋巴细胞凋亡率与涂阴组和健康对照组差异有显著性(P<0.05);复治组外周血CD4+T淋巴细胞凋亡率显著高于初治组和对照组;外周血CD4+T淋巴细胞凋亡率与TNF-α及IL-10水平呈正相关(P<0.05)。结论外周血CD4+T淋巴细胞凋亡率与TNF-α及IL-10水平呈正相关,均参与了对结核杆菌感染的免疫病理过程。

Objective To study the role of plasma levels of cytokine TNF-α and interleukin-10（IL-10）and apoptosis of T-cell in the immunopathogenesis of tuberculosis.Methods The plasma levels of TNF-α and IL-10 were detected in 45 patients with tuberculosis by erzyme-linked immunosorbent assay（ELISA）,and the CD4＋T lymphocytes subsets were detected by flow cytometry.Correlation analysis was performed.Results The contents of TNF-α and IL-10,and the apoptosis rate of CD4＋T lymphocytes in patients with tuberculosis were significantly higher than those in controls. A The apoptosis rate of CD4＋ T cells in smear-positive group was significantly higher than that in smear-negative group and in control group; the apoptosis rate of CD4＋ T cells in the retreatment group was significantly higher than that in the ini- tial treatment group and control group. Conclusion Apoptosis of CD4＋ T lyrnphoeytes was positively correlated with TNF-α and IL-10 contents. They were involved in the immunopathogenesis of tuberculosis infection.