流式细胞术检测肺泡灌洗液T淋巴细胞亚群的诊断价值

Diagnostic value of applying flow cytometry in detecting T-lymphocyte subsets in bronchoalveolar lavage fluid of patients with several common pulmonary diseases

目的探讨支气管肺泡灌洗液(BALF)中T淋巴细胞免疫活性对几种常见肺部疾病的临床诊断价值。方法选取该院2013-2015年住院患者61例,其中肺癌15例,肺结核10例,结节病13例,肺部感染15例,特发性肺间质纤维化(IPF)8例。流式细胞仪检测BALF中T淋巴细胞亚群水平。结果 CD3+、CD4+、CD8+及CD4+/CD8+在肺癌组和结节病组变化最明显,与其他组比较,差异有统计学意义(P<0.05)。肺癌组CD3+、CD4+下降,CD8+升高,CD4+/CD8+明显下降;而结节病组CD4+升高,CD8+降低,CD4+/CD8+明显升高。肺结核组与肺部感染组也表现为CD4+下降,CD8+相对升高,CD4+/CD8+下降,与结节病组及IPF组比较,差异有统计学意义(P<0.05)。IPF组CD3+、CD4+、CD8+及CD4+/CD8+均接近正常值。结论通过流式细胞技术检测BALF中T淋巴细胞亚群水平,在一定程度上可有效区分几种常见的肺部疾病,对了解患者免疫功能、疾病鉴别诊断及预后具有重要的临床价值。

Objective To evaluate the clinical diagnosis value of T-lymphocyte cell activenss in bronchoalveolar lavage fluid（BALF）of patients with several common pulmonary diseases.Methods 61 cases of inpatients in this hospital from 2013 to 2015 were selected,including 15 cases of lung cancer,10 cases of pulmonary tuberculosis,13 cases of sarcoidosis,15 cases of pulmonary infection,8 cases of idiopathic pulmonary interstitial fibrosis（IPF）.The levels of T lymphocyte subsets in BALF were detected by flow cytometry.Results CD3＋,CD4＋,CD8＋ and CD4＋/CD8＋ were obviously changed in the group of lung cancer and sarcoidosis,the difference was statistically significant（P〈0.05）.In the group of lung cancer,CD3＋ and CD4＋ were lowered,CD8＋ was increased,and CD4＋/CD8＋ was significantly lowered.However,in the group of sarcoidosis,CD4＋ was increased,CD8＋ was lowered,and CD4＋/CD8＋ was significantly increased.In addition,in the group of tuberculosis and pulmonary infection,CD4＋ was lowered,CD8＋ was comparatively increased,and CD4＋/CD8＋ was significantly lowered,they were significantly different from sarcoidosis and IPF（P〈0.05）.In the group of IPF,CD3＋,CD4＋,CD8＋ and CD4＋/CD8＋ were closed to normal value.Conclusion Detecting the level of T-lymphocyte subsets in BALF helps differentiating the above-mentioned pulmonary diseases effectively to some extent,thus it has important value in exploring the immune function of patients and disaese differential diagnosis and prognosis.