T淋巴细胞亚群及Th细胞的变化和初治肺结核患者预后的关系

Cure tuberculosis patients at the beginning of the change of T lymphocyte subsets and Th cells and its relationship with prognosis

目的 探讨初治肺结核患者T淋巴细胞亚群和Th细胞的变化及与预后的关系。方法 收集在我院感染科结核门诊治疗的初治肺结核患者，收集时间为20l1年1月至2013年6月，共计60例，记为肺结核治疗组，按初治疗效进一步将肺结核组分为亚组：好转组与未好转组。健康未患肺结核的人群，共30例。测定外周血T细胞亚群及代表rrh细胞的IFN～7、IL-4。结果 初治肺结核患者治疗开始时，未好转组CD4＋、CD4＋／CD8＋、Thl（30．25±5．93、1．07士0．13、5．03±1．17）表达较健康组与好转组降低更明显，Th2（5．66±0．76、）最高（P〈0．05），好转组CD4＋、CD4＋／CD8＋、Thl（36．77±6．90、1．43±0．40、7．48±2．63）表达较健康组表达低，好转组Th2（4．62±1．1）表达较健康组高（P〈0．05），健康组CI）4＋、CD4＋／CD8＋、Th40．38士7．65、1．68±0．68、12．20±1．90）表达最高，Th2（3．10±0．82）最低（P〈0．05）。肺结核组和健康组比较CI）8＋无显著变化（P〉0．05）。治疗结束时与未好转组和治疗前自身比较，好转组CD4＋、CD4＋／CD8＋、Thl（38．67土7．05、1．56±0．46、8．1 3±2．54）明显升高（Pc=0．05），Fh2（3．75±0．93）显著降低，差异有统计学意义（P〈0．001）；与治疗前比较，未好转组治疗后cD4＋、cD4＋／CD8＋、Thl、Th2（31．06±3．32、1．07±0．27、4．67±1．01、5．28±0．89）无变化，差异无统计学意义（P〉0．05）。结论初治肺结核患者CD4＋、CD4＋／（3D8）、Thl较正常人降低，Th2较正常人升高。肺结核治疗初期，CD4＋、CD4＋／CD8＋、Thl偏高，Th2低的患者预后较好。治疗有效后CD4＋、CD4＋／CD8＋、Fhl升高，TH2下降。

Objective evauate the cure tuberculosis patients in the early changes of T lymphocyte subsets and Th ceils and its relationship with prognosis. Methods Collected in our hospital infection with the tuberculosis outpatient treatment of tuberculosis patients treated first, collection time for be-tween January 2011 and June 2011, a total of 60 cases, notes for tuberculosis treatment group, according to early cure tuberculosis group curativeeffect is further divided into subgroups： improved group and did not get better. Healthy people without tuberculosis, a total of 30 cases. Determinationof peripheral blood T cells subgroup, Th and IFN - gamma, IL - 4. Results Not better cure tuberculosis patients in the early start of treatmentgroup, CD4 Jr＋, CD4＋/CDS＋ and Thl （plus or minus 30.25：：5.93,1.07±0.13,5.03.4± 1.17） express healthier and better group reduced more apparent, Th2（5.66：L0.76） is highest （P〈0.05）, improving group of CD4＋, CD4＋/CDS＋ and Thl （36. 7746.90,1.43±0. 40,7.48 h2.63） ex-pression was lower than those of healthy group expression, improving group Th2 （4.62± 1. 12） expression was a litle higher in the healthy group （ P〈0.05）, a healthy set ofCD4＋, CD4＋/CDSq and Thl （40.38±0. 65,1. 684 0. 68,12. 20±l. 90）the highest expression, Th2 lowest （3. 10＋0.82） （P〈0.05）. End with no improvement and itself before treatment, improveCD4＋,CD4＋/CDS＋,Th1（38. 67±7.05,1.56±0.46,8. 13±2.5,1） increased significantly, the Th2 significantly lower（3.75±0.93）, the difference was statistically significant （P〈0. 001 ） ; Compared with beforetreatment, no improvement after treatment of CD4＋,CD4＋/CD8＋,Thl,Th2（31.06 ±3.32,1.07±0.27,4.67± 1.01,5.28±10.89）no change, thedifference was statistically significant （P〉0.05）. Conclusion early cure tuberculosis patients CD4 ＋, CD4＋CD8 ＋ and Thl reduced significantly,Th2 increased significantly. Tuberculosis treatment early, CD4 Jr, CD4 ＋CD8＋ and Thl on the high side, low Th2 patients prognosis is good. Effective after treatment of CD4＋ CD4＋/CDS＋, Thl/Th2, Thl, Th2 decline.