耐多药肺结核患者外周血中淋巴细胞比例变化分析

Change of lymphocyte percentage in peripheral blood in patients with multidurg-resistant pulmonary tuberculosis

目的探讨耐多药(MDR)肺结核患者外周血中淋巴细胞亚群的表达及其临床意义。方法采取92例健康体检者(HC)、96例非耐药初治肺结核(DS-TB)患者及38例耐多药结核病(MDR-TB)患者2 m L EDTA抗凝外周静脉血,经抗体标记后,采用FACSCalibur流式细胞仪检测淋巴细胞亚群,对三组数据进行对比分析。结果DS肺结核组、MDR肺结核组及对照组之间的CD_4^+T淋巴细胞和B淋巴细胞的表达率比较,差异无统计学意义(P>0.05)。CD_3^+T淋巴细胞的表达在MDR肺结核组中出现了下降(P<0.05),而DS肺结核组没有变化。CD_8^+T淋巴细胞的表达在DS肺结核组中要显著高于健康组和MDR肺结核组(P<0.05),健康组和MDR肺结核之间没有差异(P>0.05)。DS肺结核组和MDR肺结核组中CD_4^+CD25H/CD3调节性T细胞的表达都明显高于健康对照组(P<0.001),差异具有统计学意义。但是DS肺结核组和MDR肺结核组之间的表达没有差异(P>0.05)。NK细胞的表达在DS肺结核组中要显著低于健康组和MDR肺结核(P<0.05),健康组和MDR肺结核之间没有差异(P>0.05)。单核细胞的表达水平分析发现,DS肺结核组和MDR肺结核组的表达显著高于健康组(P<0.001),而DS肺结核组和MDR肺结核组之间的表达没有差异(P>0.05)。结论机体在感染了结核杆菌后,体内的天然免疫应答和特异性免疫应答功能会发生改变。本研究发现DS肺结核组和MDR肺结核组之间的免疫功能存在一些差异。了解DS肺结核组和MDR肺结核组之间的免疫功能差异,能够为我们阐明其相关的免疫发病机制,从而为进行免疫干预,以及结核病的治疗提供重要的理论依据。

Objective To evaluate the changes and significance of lymphocyte subsets in peripheral blood of patients with multidurg-resistant pulmonary tuberculosis. Methods 92 cases of healthy controls （ HC ）,96 cases of patients with susceptible primary tuberculosis （ DS）,and 38 cases of patients witli multidrug-resistant pulmonary tu-berculosis （MDR） were involved. 2 ml of peripheral venous blood was injected into EDTAtube,labeled with mono-clonal antibody. The results of the three group were detected by BD FACSCalibur and analyzed5. 0. Results The percentage of CD4^＋ T cells and B cells had no statistical significance between DS-TB and MRD-TB （P 〉 0. 05 ） . The percentage of CD3＋ T cells in the MDR-TB group was significantly lower than that in the HC group （P 〈0. 05）,but tliere was no change in the DS-TB group. The percentage of CD4^＋ T cells in the DS-TB group wassignificantly higher than that in the HC group and the MDR-TB group （P 〈0. 05）,and there waicance between the HCgroup and the MDR-TBgroup （P 〉0. 05）. The percentage of CD4^＋CD25H/CD3 T cells in the DS-TB and the MDR-TB group were significantly higher than that in the HC no statistical significance between the DS-TB group and the MDR-TB group （ P 〉 0. 05 ）. The percin the DS-TB group was significantly lower than that in the HC group and the MDR-TB group （P 〈0. 05）,and therewas no statistical significance bet^veen the HC group and the MDR-TB group （ P 〉 0. 05 ） . The percentage of mono-cyte in the DS-TB and the MDR-TB group was significantly higher tlian that in the HC group （ P 〈0. 001）,and there was no statistical significance between the DS-TB group and the MDR-TB group （ P 〉 0. 05 ）. Conclusion When people are infected with TBbacilli,the bodys natural immune response and specific immune response change. In this study,some different changes are found between the DS-TB and MDR-TBmore easy for us to expound the related immune pathogenesis,and provide important theoretical basis intervention and the treatment of tuberculosis.