炎症性肠病患者T淋巴细胞亚群的改变及临床意义

Clinical Significance of T-Lymphocyte Subsets Changes in Inflammatory Bowel Disease

目的：探讨炎症性肠病（ＩＢＤ）患者外周血Ｔ淋巴细胞亚群的变化特点及临床意义。方法：对临床确诊的１８例溃疡性结肠炎（ＵＣ）和９例Ｃｒｏｈｎ病（ＣＤ）患者，于疾病的不同时期用荧光单克隆抗体标记一流式细胞仪技术检测其外周血Ｔ淋巴细胞亚群的变化，并结合临床和病理资料进行综合分析。结果：ＵＣ患者缓解期时的ＣＤ３＋、ＣＤ８＋和自然杀伤（ＮＫ）细胞与对照组比较无显著差异；但活动期时，其ＣＤ８＋和ＮＫ细胞数明显下降（ＣＤ８＋：活动期：２３．１％±１．０％，对照组：３１．３％±１．２％，Ｐ＜０．０５；ＮＫ：活动期：９．８％±１．０％，对照组：１５．１％±１．１％，Ｐ＜０．０１），ＣＤ４＋／ＣＤ８＋比值上升（活动期：１．８±０．１，对照组：１．４±０．０２，Ｐ＜０.０５）；活动期ＣＤ患者的ＣＤ８＋细胞和ＣＤ４＋／ＣＤ８＋比值（４３．０％±４．４％和０．６±０．１）变化却与ＵＣ组活动期呈相反趋势（Ｐ＜０．０１）。结论：Ｔ淋巴细胞亚群改变在ＩＢＤ的发病机制中可能起重要作用；ＵＣ和ＣＤ的细胞免疫机制不同；外周血ＣＤ４+、ＣＤ８＋、ＮＫ细胞和ＣＤ４＋／ＣＤ８＋比值可作为检测ＵＣ病情变化和疗效考核的敏感指标。

Background/Aims: To investigate the changes and clinical significance of peripheral blood T-lym- phocyte subsets in patients with inflammatory bowel disease (IBD) during various stages. Methods: 18 patients with ulcerative colitis (UC), 9 with Crohn disease (CD) and 10 normal volunteers were re- cruited in this study. The T-lymphocyte subsets were investigated by immunofluorescence flow cyto- metry analysis and analyzed with clinical activity index. Results: Compared with controls, no signifi- cant difference in CD３+, CD８+ and natural killer (NK) cells were observed in inactive stage of UC. But in active stage of UC, CD８+ and NK cells decreased significantly (CD８+: 23.1%±1.0% vs 31.3%±1.2%, P<0.05;NK:9.8%±1.0% vs 15.1% ± .1%, P< 0.01), and CD.+/CD,+ ratio increased (1.8t0.1 vs 1.4t 0.02, P<0.05). The changes of CD,+ and CD,+/CD,+ ratio in active stage of CD were contrary to those o f UC in the active stage (P<0.01). Conclusions: Alteration of T-lymphocyte subsets may contribute to the pathogenesis of active UC inflammation. The disorders of T-lymphocyte subsets may play dif－ ferent role in UC and CD. The number of CD4+, CD8+, NK cells and CD4+/CD8+ ratio may be valuable in monitoring the disease stages and in guidance of treatment.