梅毒血清固定患者外周血淋巴细胞亚群与快速血浆反应素效价的相关性

Analysis of peripheral blood lymphocyte subsets and its correlation with the rapid plasma reagin titers in serofast syphilis patients

目的探讨梅毒血清固定患者快速血浆反应素（RPR）持续阳性的原因，为临床治疗和预后评估提供参考依据。方法应用流式细胞仪检测33例血清固定患者和23例健康对照者外周血CD3^＋、CD4^＋、CD8^＋T淋巴细胞和NK细胞的百分比，并应用FlowCount荧光球进行绝对计数。统计学处理采用独立样本t检验，双变量线性相关分析血清固定患者淋巴细胞亚群的变化与RPR效价的相关性。结果与健康对照者相比，梅毒血清固定患者CD3^＋、CD8^＋T淋巴细胞百分比明显增加，分别为（75．75±5．76）oA比（68．37±5．80）％（f=4．69，P〈0．01）和（27．34±7．02）％比（24．33±1．95）％（t=2．34，P=0．025）；NK细胞百分比和绝对值均明显下降，分别为（7．32±4．48）％比（14．87±6．26）％（t=5．269，P〈0．01）和（136．2±83．4）／肛L比（298．8±166．9）／μL（t：4．311，P〈0．01）。血清固定患者RPR效价与CD4’T淋巴细胞百分比和绝对值呈负相关（r值分别为-0．476、-0．515，均P〈0．01），与CD8^＋T淋巴细胞呈正相关（r值分别为0．588、0．305，P〈0．01、P=0．804）。结论梅毒血清固定患者机体内淋巴细胞亚群免疫应答反应出现失衡，可能是导致其RPR效价变化的原因。

Objective To investigate the reason of persisting positive rapid plasma reagin （RPR） in serofast syphilis patients, and to provide reference for clinical treatment and prognosis. Methods A total of 33 serofast patients and 23 healthy controls were enrolled in this study. The percentages and absolute counts of CD3^＋, CD4^＋, CD8^＋ T lymphocytes and natural killer （NK） cells were detected by flow cytometry. The comparison of two groups was analyzed by independent sample t test, and the correlation between change of lymphocyte subgroups and RPR titer in serofast syphilis patients was analyzed by bivariate linear correlation method. Results Compared with healthy controls, the percentages of CD3^＋ , CDS＋T lymphocytes in serofast syphilis group were both increased significantly （75. 75 ±5. 76）% vs （68. 37 ± 5.80）%, （t=4.69, P〈0.01）; （27.34±7.02）% vs （24.33=1.1.95）%, （t=2.34, P=0.025）, while both the percentage and absolute count of NK cells were significantly decreased （7.32 ±4.48）% vs （14.87± 6.26） %, （t=5.269, P〈0.01）; （136.2±83.4）/μL vs （298.8± 166.9）/μL, （t=4.311, P〈0.01）. RPR titer of the patients was negatively correlated with both percentage and absolute count of CD4^＋ T lymphocytes （r= -0. 476 and -0. 515, respectively, both P〈0.01）, and it was positively correlated of CD8^＋lymphocytes （r=0. 588 and 0. 305, P 〈0. 01 and P=0. 804）. Conclusion The imbalance of immune response of lymphocyte subsets observed in serofast syphilis may explain the RPR titers change.