淋巴细胞及细胞因子在肺结核患者体内的监测意义

Significance of Monitoring of Lymphocytes and Cytokines in Patients with Pulmonary Tuberculosis

目的探讨淋巴细胞及细胞因子在肺结核患者体内的监测意义。方法选择2010年2月至2012年2月于我院住院的86例肺结核患者,根据病情将其分为活动性肺结核组32例、非活动性肺结核组54例,选取同期进行健康体检的人员47例为正常对照组。所有实验对象均于清晨空腹采集肘正中静脉血4mL,用于检测T淋巴细胞亚群和细胞因子。结果与正常对照组比较,活动性肺结核组和非活动性肺结核组患者CD3+、CD4+T淋巴细胞明显降低,CD8+明显升高(P<0.05),其中,活动性肺结核组患者CD3+、CD4+T淋巴细胞降低最多,CD8+升高最明显,与非活动性肺结核组患者比较差异有统计学意义(P<0.05);与正常对照组比较,活动性肺结核组和非活动性肺结核组患者IL-4、IL-10、TNF-α明显升高,IFN-γ明显降低(P<0.05),其中,活动性肺结核组患者IL-4、IL-10、TNF-α升高最多,IFN-γ降低最明显,与非活动性肺结核组患者比较差异有统计学意义(P<0.05)。结论对肺结核患者进行CD3+、CD4+、CD8+T淋巴细胞亚群以及IL-4、IL-10、TNF-α、IFN-γ细胞因子的检测,对判断肺结核患者病情变化和结核活动情况有重要意义,值得临床深入研究。

Objective To explore the significance of monitoring of lymphocytes and cytokines in patients with pulmonary tuberculosis. Methods 86 patients with pulmonary tuberculosis in our hospital from February 2010 to February 2012 were selected and divided into active pulmonary tuberculosis group （n = 32） and inactive pulmonary tuberculosis group （n = 54）. 47 healthy people at the same period were selected as the control group. The venous blood （4 mL） was collected in all cases to detect the lymphocyte subsets （CD3＋, CD4＋, CD8＋ T） and cytokines （IL-4, IL-10,TNF-α, IFN-γ）. Results Compared with the control group, CD3＋ and CD4＋ T lymphocyte decreased and CD8＋ increased significantly in patients with pulmonary tuberculosis （P 〈0.05）, and especially in the active pulmonary tuberculosis group （compared with inactive pulmonary tuberculosis group, P〈0.05）. Compared with the control group, IL-4, IL-10, TNF-a increased and IFN-y decreased significantly in patients with pulmonary tuberculosis （P 〈0.05）, especially in the active pulmonary tuberculosis group （compared with inactive pulmonary tuberculosis group, P〈0.05）. Conclusions The detection of lymphocyte subsets （CD3＋, CD4＋, CD8＋ T） and cytokines （IL-4, IL-10, TNF-α, IFN-γ） in patients with pulmonary tuberculosis has important significance in evaluating the condition changes and tuberculosis activity, which is worthy of clinical intensive study.