空洞型肺结核患者化学治疗过程中白细胞的动态分析

Dynamic analysis of white blood cells in patients with cavitary pulmonary tuberculosis during chemotherapy procedure

目的分析空洞型肺结核（CPTB）患者化学治疗过程中白细胞的动态变化,监视患者在治疗过程中的细胞免疫状态,为寻找可评估疗效和预后的免疫学指标提供理论依据。方法选取85例CPTB患者（CPTB组）和100例体检健康者（对照组）,检测CPTB组治疗前和对照组各项白细胞指标比较差异,并分析CPTB患者各项指标在治疗过程中的动态变化。结果治疗前CPTB患者淋巴细胞绝对值及百分比低于对照组,而白细胞总数,中性粒细胞绝对值及百分比、单核细胞绝对值及百分比均高于对照组,差异均有统计学意义（P〈0.05）。治疗1-3个月,除淋巴细胞绝对值维持在较低水平外,其他各项指标在治疗后均有不同程度的升高或降低。结论化学治疗后,淋巴细胞介导的免疫处于抑制状态;白细胞的动态变化可反映CPTB患者治疗过程中的细胞免疫状态,对疗效和预后的评估具有一定的指导意义。

Objective To analyze the dynamic changes of white blood cells in patients with cavitary pulmonary tuberculosis （CPTB） during chemotherapy procedure ,and explore immunological indexes which could evaluate the curative effect and prognosis . Methods 85 cases of patients with CPTB （CPTB group） and 100 healthy people conducted physical examination （control group） were enrolled in this study ,The immunological indexes of white blood cells were detected and compared between CPTB group and control group ,and dynamic changes of white blood cells were analyzed in patients with CPTB .Results Compared with the control group ,absolute lymphocyte count and percentage of lymphocyte were decreased in the CPTB group before chemotherapy ,while the total white blood cells count ,absolute neutrophil count and percentage of neutrophil ,absolute monocyte count and percentage of monocyte were increased in the CPTB group before chemotherapy ,there were statistically significant differences between the two groups（P〈0 .05） .Except the absolute lymphocyte count ,other indexes were statistically increased or decreased during chemothera‐py procedure .Conclusion After chemotherapy ,the immunological reactions induced by lymphocyte are under inhibitory state .The dynamic changes of white blood cells could reflect the state of cellular immunity in patients with CPTB during chemotherapy ,which could be helpful for the evaluation of curative effect and prognosis .