肺结核患者T细胞亚群及炎性因子水平对患者预后的影响

Effect of T cell subset and inflammatory cytokine levels on prognosis in patients with pulmonary tuberculosis

目的：探讨肺结核患者T细胞亚群及炎性因子的水平及对患者预后的影响。方法：选取2013年2月~2015年2月经我院传染科确诊为结核病患者72例设为实验组,其中活动性肺结核患者58例,静止性肺结核患者14例;选取同期于我院体检健康者50例设为对照组,分别于治疗前和治疗6个月后对两组进行痰菌检测,记录痰菌转阴率、检查肺部病灶的吸收以及空洞闭合情况,对患者T细胞亚群中各免疫细胞功能再次检测。结果：实验组患者外周血中CD3、CD4、CD8、CD4/CD8均明显低于对照组,尤以实验组中活动性肺结核患者明显（P〈0.01）,而在实验组静止性活动患者外周血中CD4/CD8较对照组低,较活动性肺结核患者高（P〈0.01）。实验组患者实验组患者血清中IL-1、IL-6、TNF-α的量明显高于对照,尤以实验组中活动性肺结核患者明显（P〈0.01）。结论：细胞亚群及炎性因子在肺结核患者中发挥着重要的作用,其动态变化可以有效的显示患者免疫功能及患者病情的严重程度,对于判断和了解肺结核患者病情的变化以及评估其预后都要着重要的价值,值得临床进一步探究。

Objective：To explore the effect of T cell subset and inflammatory cytokine levels on the prognosis in pa-tients with pulmonary tuberculosis.Methods：A total of 72 patients confirmed with pulmonary tuberculosis who were admitted in our hospital from February,2013 to February,201 5 were included in the study and served as the experiment group,among which 58 cases had active tuberculosis,and 14 cases had static tuberculosis;while 50 healthy individuals who came for physical examinations were served as the control group.The sputum bacteria before treatment and 6 months after treatment in the two groups were detected.The sputum negative conversion rate was recorded.The absorption of pulmonary lesions and the closure of tuberculosis cavity were examined.The immune cell function of T cell subset was detected again.Results：The peripheral blood CD3,CD4,CD8,and CD4/CD8 levels in the experiment group were significantly lower than those in the control group,nbsp;especially for the active tuberculosis patients （P 〈0.01）.The peripheral blood CD4/CD8 levels in the static tuberculosis pa-tients was lower than that in the control group,but was significantly higher than that in active tuberculosis patients （P 〈0.01）. The serum IL-1,IL-6,and TNF-αlevels in the experiment group were significantly higher than those in the control group,es-pecially for the active tuberculosis patients （P 〈0.01）.Conclusions：The cell subsets and inflammatory cytokines play an im-portant role in patients with pulmonary tuberculosis,whose dynamic change can effectively display the immune function and se-verity degree,which is of great value in estimating the condition and assessing the prognosis;therefore,it deserves to be fur-ther explored in the clinic.