培阳肺结核和非结核分枝杆菌肺病患者外周血T淋巴细胞亚群的分析研究

Analysis of T Lymphocyte in Peripheral Blood of Patients with Sputum Culture Positive Tuberculosis and Non-tuberculosis Mycobacterium Tuberculosis

目的:检测并分析培阳肺结核和非结核分枝杆菌(NTM)肺病患者外周血T淋巴细胞亚群的变化。方法:选取2020年3-11月笔者所在医院收治的培阳肺结核、NTM肺病患者各40例,分别设为培阳肺结核组、NTM肺病组;另选取同期健康体检者40例设为健康组。采用流式细胞术测定其CD4^(+)、CD8^(+)、CD4^(+)与CD8^(+),收集患者临床资料,并对数据进行统计学分析。结果:培阳肺结核组抗酸杆菌涂片、T-SPOT检测、PPD试验阳性患者例数均高于NTM肺病组,差异均有统计学意义(P<0.05),两组侵犯肺野均数、营养不良情况、体重、基础疾病患者例数比较差异均无统计学意义(P>0.05)。NTM肺病组CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)均低于健康组,差异均有统计学意义(P<0.05);培阳肺结核组CD4^(+)低于健康组,差异有统计学意义(P<0.05),CD8^(+)、CD4^(+)/CD8^(+)与健康组比较差异无统计学意义(P>0.05);NTM肺病组CD4^(+)、CD4^(+)/CD8^(+)均低于培阳肺结核组,差异均有统计学意义(P<0.05),NTM肺病组CD8^(+)与肺结核组比较差异无统计学意义(P>0.05)。结论:培阳肺结核和非结核分枝杆菌肺病患者外周血T淋巴细胞亚群存在差异,能为临床对肺结核与非结核分枝杆菌肺病患者病情判断、治疗干预提供参考依据。

Objective:To detect and analyze the changes of T lymphocyte in peripheral blood of patients with sputum culture positive tuberculosis and non-tuberculous mycobacteria (NTM).Method:A total of 40 patients with sputum culture positive tuberculosis and NTM lung disease who were treated in the author’s hospital from March to November 2020 were selected and set as the sputum culture positive tuberculosis group andthe NTM lung disease group respectively,another 40 healthy subjects were selected as the healthy group.CD4^(+),CD8^(+),CD4^(+)/CD8^(+) were determined by flow cytometry,clinical data of the patients were collected and analyzed statistically.Result:The number of positive patients with acid-fast bacilli smear,T-SPOT test and PPD test in the sputum culture positive pulmonary tuberculosis group was higher than that in the NTM lung disease group,the differences were statistically significant (P<0.05),there was no statistical significance in the mean number of lung field invasion,malnutrition,body weight and the number of patients with basic diseases between the two groups (P>0.05).The CD4^(+),CD8^(+) and CD4^(+)/CD8^(+) in the NTM lung disease group were lower than those in the healthy group,the differences were statistically significant (P<0.05),CD4^(+) in the sputum culture positive pulmonary tuberculosis group was lower than that in the healthy group,the difference was statistically significant (P<0.05),there was no statistically significant difference in CD8^(+),CD4^(+)/CD8^(+) compared with healthy group (P>0.05),CD4^(+) and CD4^(+)/CD8^(+) in the NTM lung disease group were lower than those in the sputum culture positive pulmonary tuberculosis group,the differences were statistically significant (P<0.05),there was no significant difference in CD8^(+) between NTM lung disease group and tuberculosis group (P>0.05).Conclusion:The difference of T lymphocyte subsets in peripheral blood of patients with sputum culture positive tuberculosis and non-tuberculous mycobacterium pulmonary disease can provide a reference for clinical diagnosis and treatment intervention of patients with tuberculosis and non-tuberculous mycobacterium pulmonary disease.