抗结核急性药物性肝损伤患者外周血T细胞亚群和NK细胞水平研究

T-lymphocyte subsets and NK cells level in peripheral blood of TB patients accompanying by acute liver injury with anlituberculolic drugs

目的探讨分析抗结核急性药物性肝损伤外周血T细胞亚群和NK细胞变化及意义。方法应用流式细胞术检测41例抗结核急性药物性肝损伤患者、209例抗结核肝功能正常患者外周血T细胞亚群和NK细胞水平,分析各组间指标变化的差异。结果抗结核急性药物性肝损伤组流式细胞术检测CD3+细胞56.3%±11.2%,CD3+CD4+细胞36.1%±8.7%,CD3+CD8+细胞20.7%±8.3%,CD4+/CD8+比值1.7±0.3,NK细胞26.8%±11.4%;抗结核肝功能正常组CD3+细胞75.8%±7.6%,CD3+CD4+细胞37.2%±9.7%,CD3+CD8+细胞26.4%±8.8%,CD4+/CD8+比值1.3±0.2,NK细胞15.4%±5.6%;CD3+细胞、CD3+CD8+细胞、CD4+/CD8+比值、NK细胞各组间比较差异均有统计学意义(P<0.01);CD3+CD4+细胞组间比较差异无统计学意义(P>0.05);结论外周血T细胞亚群CD3+细胞、CD3+CD8+细胞减少,CD4+/CD8+比值、NK细胞增加在抗结核急性药物性肝损伤疾病的发生发展中起到了一定的作用。

Objective To investigate the change and significance of T - lymphocyte subsets and MK cell in peripheral blood of TB patients with acute liver injury treated by antituberculotic drugs. Methods Flow - cytometry was used to detect the levels of T - lymphocyte subsets and MK cell in 41 TB patients with acute liver injury and 209 TB cases with normal liver function, then the difference of index levels was analyzed between two groups. Results The levels of CD3 ＋ cells, CD3 ＋ CIM ＋ cells, CD3 ＋CD8 ＋ cells, CIM ＋/CD8 ＋ and NK cells were56.3% ± 11.2%, 36.1% ± 8.7%,20.7 % ± 8.3%, 1.7 ± 0.3, and 26.8 % ± 11.4% respectively in antituberculosis drug- induced acute liver injury group, while those in antitubercular normal liver function group were 75.8% ± 7.6%, 37.2% ± 9.7%, 26.4% ± 8.8%, 1.3 ± 0.2 and 15.4% ±5.6%. The difference of CD3 ＋ cells, CD3 ＋ CD8 ＋ cells, CIM ＋/CD8 ＋ ratio, NK cells had statistical significance among the three groups （ P 〈 O. O1 ）, while CD3 ＋ CD4 ＋ cells differences had no statistical significance （ P 〉 0.05 ）. Conclusion The decrease Of CD3 ＋ cells and CD3 ＋ CD8 ＋ cells, and increase of CD4 ＋/CD8 ＋ and NK cells in the peripheral blood may be involved in the pathogenesis and progress of acute liver injury in TB patients with antituberculotie drugs.