不同时期布鲁菌性脊柱炎患者T淋巴细胞亚群的变化研究

Changes in T lymphocyte subsets in patients with Brucellar Spondylitis in different stages

目的通过对不同分期布鲁菌性脊柱炎(Brucellar spondylitis,BS)患者外周血T淋巴细胞亚群进行测定分析,以明确布鲁菌性脊柱炎感染的不同阶段体内的免疫状态,为有效减少布鲁菌性脊柱炎的慢性化提供研究方向。方法收集2016年5月至2020年5月确诊的120例布鲁菌性脊柱炎患者的资料进行回顾性分析,分为急性期组70例,慢性期组50例,健康对照组30例,通过流式细胞术检测外周血T淋巴细胞亚群的表达水平,对比分析不同时期BS的临床特征、T淋巴细胞亚群数值变化。结果急性期患者70例,慢性期患者50例,男性多于女性,腰部疼痛临床表现较为明显。急性期BS患者血清血沉(ESR)、超敏C反应蛋白(hs-CRP)水平明显升高,与慢性期组和健康对照组比较差异均有统计学意义(P<0.05)。急性期患者CD_(3)^(+)T淋巴细胞、CD_(3)^(+)CD_(8)^(+)T淋巴细胞数值增高,与慢性期组患者和健康对照组比较差异有统计学意义(P<0.05);急性期、慢性期患者CD_(3)^(+)CD_(4)^(+)T淋巴细胞数值均下降,与健康对照组比较差异有统计学意义(P<0.05)。结论布鲁菌性脊柱炎患者体内存在明显的免疫功能紊乱现象,急性期CD_(3)^(+)T淋巴细胞和CD_(3)^(+)CD_(8)^(+)T淋巴细胞的数值升高,有利于机体对病原体的清除,慢性期细胞免疫反应被抑制,易导致慢性化和并发症的发生。

Objective To analyze T lymphocyte subsets of peripheral blood in patients with Brucellar Spondylitis(BS)in different stages,and clarify the immune status in vivo during different stages,and provide research direction for reducing BS chronicity.Methods A total of 120 confirmed BS cases collected from May 2016 to May 2020 were retrospectively analyzed and divided into the acute stage group with 70 cases,chronic stage group with 50 cases and control group with 30 cases.The expression levels of peripheral blood T lymphocyte subsets were detected by flow cytometry(FCM),and clinical characteristics and T lymphocyte subsets of BS in different stages were contrastively analyzed.Results There were 70 acute and 50 chronic BS patients,males were more than females,lumbar pain was most common in clinical manifestations.The levels of erythrocyte sedimentation rate(ESR)and high sensitivity C-reactive protein(hs-CRP)in the acute stage group were significantly higher relative to the chronic stage group and the control group(P<0.05).CD_(3)^(+)T lymphocytes,CD_(3)^(+)CD_(8)^(+)T lymphocytes increased in the acute stage group increased,and the differences was statistically significant between the acute stage group and the other groups(P<0.05).Decreased CD_(3)^(+)CD_(4)^(+)T lymphocytes were found in the acute&chronic stage groups,and the difference was statistically significant between the acute&chronic stage groups and control group(P<0.05).Conclusion Immune dysfunction are found in BS patients,increasing CD_(3)^(+)T lymphocytes and CD_(3)^(+)CD_(8)^(+)T lymphocytes in the acute stage contribute to eliminating pathogens,while inhibited cellular immune response in the chronic stage is apt to cause chronicity and complications.