肺结核患者临床特征与外周血流式细胞亚群的相关性分析

Correlation analysis between clinical characteristics and flow cytometry cells subsets in peripheral blood of patients with pulmonary tuberculosis

目的了解肺结核患者临床特征与外周血流式细胞亚群[T淋巴细胞亚群及自然杀伤(NK)细胞]的相关性。方法连续性收集2019年1月1日至5月25日期间同济大学附属上海市肺科医院肺结核住院患者1000例的临床资料进行回顾性分析。将患者各临床特征数据与外周血流式细胞亚群的检测值采用Eviews 8.0软件分别建立多元线性逐步回归模型,以明确各临床特征与外周血流式细胞亚群的检测值之间的相关性。结果(1)肺结核患者的肺部病灶范围及呼吸道标本抗酸染色涂片结果与CD3^+T细胞表达有关:肺部病灶范围越大、呼吸道标本抗酸染色涂片阳性程度越高,CD3^+T细胞数量越低(回归系数分别为-0.255、-0.499,P值分别为0.021、0.027)。(2)患者的年龄、性别、结核分子生物学检测结果与CD4^+T细胞表达有关:0~<20岁年龄段患者CD4^+T细胞数量低于其他年龄段患者(回归系数-4.710,P=0.031);男性CD4^+T细胞数量低于女性患者(回归系数-2.150,P=0.001);分子生物学检测阳性的患者CD4^+T细胞数量高于检测阴性的患者(回归系数1.433,P=0.030)。(3)初治患者CD8^+T细胞数量高于复治患者(回归系数1.247,P=0.029);呼吸道标本抗酸染色涂片阳性程度越高CD8^+T细胞数量越高(回归系数0.442,P=0.033)。(4)并发肺外结核者的NK细胞低于未并发肺外结核者(回归系数0.375,P=0.030)。结论肺结核患者的肺部病灶累及范围、呼吸道标本抗酸染色阳性与外周血流式细胞亚群CD3^+T细胞具有相关性;年龄、性别、结核分子生物学检测结果与CD4^+T细胞具有相关性;是否初治、呼吸道标本抗酸染色阳性与CD8^+T细胞具有相关性;是否并发肺外结核与NK细胞表达水平具有相关性。

Objective To understand the correlations between clinical characteristics of patients with pulmonary tuberculosis(PTB)and flow cytometry subsets of T cells and natural killer(NK)cells.Methods One thousand continuously admitted patients diagnosed as PTB in Shanghai Pulmonary Hospital from January 1,2019 to May 25,2019 were retrospective enrolled for analysis.Multiple linear stepwise regression models were established with Eviews 8.0 software to determine the correlations between clinical characteristics and values of flow cytometry cell subsets in peripheral blood.Results(1)The degree of lung lesion range and acid-fast staining smear from respiratory specimens in patients with PTB were positively related with the frequency of CD3^+T cells:the larger lung lesion range and the higher the positive degree of acid-fast staining smear,the lower the frequency of CD3^+T cells was(regression coefficient was-0.255 and-0.499 respectively,P value was 0.021 and 0.027 respectively).(2)Age,gender and tuberculosis molecular biological detection results of patients were related to the frequency of CD4^+T cells:the number of CD4^+T cells in patients aged less than 20 years was lower than that in patients with older age groups(regression coefficient-4.710,P=0.031).The frequency of CD4^+T cells in male patients was lower than that in female patients(regression coefficient-2.150,P=0.001).The frequency of CD4^+T cells in patients with positive PCR test was higher than that in patients with negative PCR test(regression coefficient1.433,P=0.030).(3)The frequency of CD8^+T cells in patients with initial treatment was higher than that in patients with retreatment(regression coefficient 1.247,P=0.029).The higher the positive degree of acid-fast staining smear,the higher the frequency of CD8^+T cells was(regression coefficient 0.442,P=0.033).(4)The frequency of NK cells of patients with extrapulmonary tuberculosis(EPTB)was lower than those without EPTB(regression coefficient 0.375,P=0.030).Conclusion The degree of pulmonary lesions and positive acid-fast staining from respiratory tract specimens in patients with PTB were correlated with frequency of CD3^+T cells.Age,sex and tuberculosis molecular biological detection results were correlated with the frequency of CD4^+T cells.CD8^+T cells was correlated with initial treatment and positive acid-fast staining.There was a correlation between frequency of NK cells and patients with PTB coexisted with EPTB.