肺结核患者肺泡灌洗液T淋巴细胞亚群水平检测意义

Significance of Level Detection of T Lymphocyte Subsets in Bronchoalveolar Lavage Fluid in Patients with Pulmonary Tuberculosis

本研究的目的是采用流式细胞仪检测肺结核(TB)患者肺泡灌洗液(BALF)T淋巴细胞亚群,探讨其临床意义。我们选取2016年1月至2016年8月我院收治的59例TB患者作为观察组,选取同期在我院健康体检者20例作为对照组。采集两组的外周血和BALF,采用流式细胞仪检测T细胞亚群水平。绘制ROC曲线,计算曲线下面积(AUC),评价CD4/CD8水平对肺结核的诊断价值。本研究结果显示观察组患者血清中和BALF中的CD4及CD4/CD8水平均低于对照组,差异具有统计学意义(p<0.05);观察组患者BALF中的CD8水平高于对照组(p<0.05);在治疗2个月后,观察组患者血清和BALF中的CD4和CD4/CD8水平均较治疗前明显升高,BALF中的CD8水平较治疗前明显降低(p<0.05);ROC曲线显示,BALF和血清中CD4/CD8诊断TB的AUC分别为0.934和0.715(p<0.05)。本研究认为检测血清和BALF中的T淋巴细胞亚群对TB的诊断和疗效观察具有一定的临床意义,其中BALF中CD4/CD8水平对TB的诊断价值较高。

The objective of the study was to detect the T lymphocyte subsets of bronchoalveolar lavage fluid （BALF） of tuberculosis （TB） patients by the flow cytometry and discusses its clinical significance. We selected 59 cases of TB patients from January 2016 to August 2016 as the observation group, and 20 cases of the healthy check-up patients as the control group at the same period. We collected the peripheral blood and BALF of the two groups and detected the T lymphocyte subsets level by the flow cytometry instrument. We drew the ROC curve, calculated the area under the curve （AUC） to evaluate the value of CD4/CD8 in diagnosis of TB. The result showed that the level of CD4 and CD4/CD8 in the serum and BALF of the observation group were significantly lower than the control group, the difference had statistical significance （p〈0.05）; The level of CD8 in BALF of observation group was higher than that of the control group, the difference has statistical significance （p〈0.05）; 2 months after treatment, the level of CD4 and CD4/CD8 in serum and BALF of the observation group was significantly elevated, the level of CD8 in BALF of the observation group was lower than that of the before treatment, the difference had statistical significance （p〈0.05）; ROC curve showed that the AUC of CD4/CD8 in BALF and serum in diagnosis of TB was 0.934 and 0.715 respectively （p 〈0.05）. In this study, we knew that the detection ofT lymphocyte subsets in serum and BALF has a certain clinical significance in the diagnosis and treatment of TB, and the level of CD4/CD8 in BALF has higher value in diagnosis of TB.