耐多药结核患者外周血Th17细胞变化及其意义

Alteration and significance of Thl7 cells in peripheral blood of patients with multidrug-resistant tuberculosis

目的观察耐多药结核(MDR-TB)患者外周血辅助性T(Th)17细胞的水平,探讨人体抵抗MDR-TB的免疫学机制。方法选取MDR-TB患者25例(MDR-TB组),初治肺结核患者23例(TB组),健康正常人25例(HC组)。采用流式细胞分析法检测各组人群外周血Th17细胞占CD4+T细胞比例。应用流式微球分析法检测各组人群外周血Th17相关的白细胞介素(IL)17和IL-6的表达。结果 MDR-TB组和TB组患者外周血Th17/CD4+T细胞比例分别为(2.18±0.65)%和(1.32±0.34)%,明显高于HC组的(0.41±0.10)%(P<0.05);MDR-TB组的Th17细胞比例亦高于TB组(P<0.05)。MDR-TB组和TB组患者外周血IL-17水平分别为(6.45±1.88)pg/ml和(3.53±0.38)pg/ml,明显高于HC组的(2.39±0.46)pg/ml(P<0.05);MDR-TB和TB组间差异亦有统计学意义(P<0.05)。MDR-TB组患者外周血IL-6水平为(571.70±188.24)pg/ml,明显高于TB组的(18.50±5.87)pg/ml和HC组的(5.76±1.86)pg/ml(P<0.05)。三组外周血IL-17水平与IL-6水平呈正相关(r=0.824,P<0.01)。结论 MDR-TB患者外周血Th17细胞比例增加,IL-17I、L-6水平升高。Th17细胞可能参与MDR-TB的发病。

Objective：To study the alteration of T help 17（Th17） cells in peripheral blood of patients with multidrug-resistant tuberculosis（MDR-TB） and explore immunologic mechanism against MDR-TB in man.Methods：With flow cytometry and cytometric bead array（CBA）,the ratio of Th17 in CD4＋T cells,interleukin（IL）-17 and IL-6 were detected in 25 patients with multidrug-resistant tuberculosis（group MDR-TB）,23 cases with pulmonary tuberculosis（group TB） and 25 healthy controls（group HC）.Results：The ratio of Th17 in CD4＋T cells was higher in groups of MDR-TB and TB than that in group HC [（2.18±0.65）% and（1.32±0.34）% vs.（0.41±0.10）%]（P0.05）,which was higher in group MDR-TB than that in group TB（P0.05）.Plasma level of IL-17 was higher in groups of MDR-TB and TB than that in group HC[（6.45±1.88） pg/ml and（3.53±0.38） pg/ml vs.（2.39±0.46） pg/ml]（P0.05）,which was higher in group MDR-TB than that in group TB （P0.05）.Plasma level of IL-17 was positively correlated to that of IL-6 in three groups（r=0.824,P0.01）.Conclusion：The ratio of Th17 in CD4＋T cells and plasma levels of IL-17 and IL-6 of peripheral blood are increased in patients with MDR-TB.Th17 cells may participate in the development of MDR-TB.