结核性胸膜炎合并慢性阻塞性肺疾病患者免疫功能的变化及意义

Immune function change and clinical significance of patients with tuberculous pleurisy complicated by chronic obstructive pulmonary disease

目的通过观察T淋巴细胞亚群、B细胞、NK细胞活性来探讨结核性胸膜炎合并慢性阻塞性肺疾病（COPD）患者免疫功能变化。方法采用流式细胞术分别测定45例结核性胸膜炎合并COPD患者（研究组）、45例COPD患者（COPD对照组）和45例健康体检者（健康对照组）外周血T淋巴细胞亚群、B细胞和NK细胞水平。结果研究组CD3＋、CD4＋、CD4＋／CD8＋、B细胞和NK细胞表达率降低，与健康对照组差异有统计学意义（P〈0．05）；COPD对照组CD3＋、CD4＋、CD4＋／CD8＋、B细胞和NK细胞表达率与健康对照组差异有统计学意义（P〈0．05）；研究组与COPD对照组的差异无统计学意义。结论结核性胸膜炎合并COPD患者免疫功能明显低于正常健康人群，增强免疫治疗非常必要。

Objective To explore the changes of immune function in patients with tuberculous pleurisy complicated by chronic obstructive pulmonary disease （COPD）. Methods 45 patients of tuberculous pleurisy com- plicated with COPD （study group） and 45 patients with COPD （COPD control group） were enrolled in the study,45 healthy subjects served as normal controls. The percentages of T lymphocyte subsets ,B cells ,NK cells in peripheral blood were measured. Result The percentages of CD3＋ ,CD4＋ ,CD4＋/CD8 ＋ , B cell and NK cells ratio in study group were lower than those in normal control group （ P 〈 0. 05 ）, The percentages of CD3＋ , CD4＋ , CD4 ＋/CD8 ＋, B cell and NK cells ratio,in COPD control group were lower than those in normal control group（P 〈0. 05）. There were no significant differences between study group and COPD control group. Conclusion Both cellular immunity and hu- moral immunity are impaired in patients with tuberculous pleurisy complicated by COPD,the impairment is more se- vere than that in patients with simple COPD. Immune therapy is very necessary to those patients.