职业性三氯乙烯药疹样皮炎患者外周血调节性T细胞水平研究

Changes of regulatory T cells in peripheral blood of patients with medicamentosa-like dermatitis due to trichloroethylene

目的研究职业性三氯乙烯药疹样皮炎(occupational medicamentosa-like dermatitis due to trichloroethylene,OMLDT)患者外周血调节性T细胞及T细胞亚群比例在不同病期中的动态变化特点。方法采用流式细胞术对28例OMLDT患者分别于急性期和临床治愈期进行外周血CD4+CD25+调节性T细胞(regulatory T cells,Tregs)及T细胞亚群比例检测,并与28例非接触三氯乙烯的健康对照进行比较。结果OMLDT临床治愈期CD4+CD25+Tregs比例为2.40%±0.42%,比急性期(比例0.97%±0.52%)明显增加,但仍低于健康对照组(4.77%±0.81%),差异均有统计学意义(P<0.01)。OMLDT临床治愈期的CD4+T细胞比例为43.29%±2.67%,显著高于急性期的30.57%±8.63%,差异有统计学意义(P<0.01),但与健康对照组(42.96%±2.48%)相比差异已无统计学意义(P>0.05)。OMLDT CD8+T细胞比例在临床治愈期为28.61%±5.14%,低于急性期的42.68%±13.07%,差异有统计学意义(P<0.01),但与健康对照组(28.38%±4.92%)相比差异已无统计学意义(P>0.05)。结论OMLDT患者调节性T细胞免疫紊乱,治疗后随病情好转有明显改善,提示三氯乙烯致药疹样皮炎与机体T细胞免疫调节功能紊乱有关。

Objective The changes of regulatory T cells and T cell subsets in peripheral blood of patients with occupational medicamentosa-like dermatitis due to trichloroethylene(OMLDT)was observed to help understand the potential mechanism of this disease.Methods The proportion of CD4+CD25+regulatory T cells(Tregs)and T cell subsets in peripheral blood of 28 patients with OMLDT in both acute stage and clinical cure stage was detected by flow cytometry,and the results were compared with those of 28 healthy persons without any TCE exposure.Results CD4+CD25+Tregs of these patients in the clinical cure stage was(2.40%±0.42%),significantly higher than that in the acute stage(0.97%±0.52%)(P<0.01),but still lower than that of the healthy persons(4.77%±0.81%)(P<0.01).The percentage of CD4+T cells in clinical cure stage was(43.29%±2.67%),significantly higher than that in acute stage(30.57%±8.63%)(P<0.01),but no difference with that of healthy persons(42.96%±2.48%)(P>0.05).The percentage of CD8+T cells in clinical cure stage was(28.61%±5.14%),significantly lower than that in the acute stage(42.68%±13.07%)(P<0.01),but no difference with that of the healthy persons(28.38%±4.92%)(P>0.05).Conclusion The regulatory T cell immune disorder in patients with OMLDT is significantly improved after treatment,which suggested that occurrence of OMLDT may be related to the disorder of T cell immune regulation.