CD3^(+)和CD4^(+)与CD8^(+)T细胞亚群及自然杀伤细胞的表达对治疗结核病的临床研究

Clinical study on the expression of CD3^(+),CD4^(+),CD8^(+)T cell subsets and natural killer cells in the treatment of tuberculosis

目的探讨CD3^(+)、CD4^(+)、CD8^(+)T细胞亚群及自然杀伤细胞(NK)的表达对治疗肺结核病的临床研究。方法选取2020年6—11月萍乡市第二人民医院收治的活动性肺结核患者(结核组)、结核潜伏感染者(结核潜伏感染组)、健康对照者(健康对照组)作为研究对象,每组30例。采用流式细胞术检查3组CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、NK细胞计数与百分比情况。结果结核组CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、NK细胞计数水平均低于结核潜伏感染组、健康对照组,差异有统计学意义(P<0.05);结核潜伏感染组CD3^(+)CD4^(+)、NK细胞计数水平均高于健康对照组,差异有统计学意义(P<0.05);健康对照组与结核潜伏感染组CD3^(+)、CD3^(+)CD8^(+)细胞计数水平比较差异无统计学意义。3组CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、NK细胞百分比情况比较差异无统计学意义;结核组CD3^(+)细胞百分比水平低于健康对照组、结核潜伏感染组,差异有统计学意义(P<0.05);结核潜伏感染组CD3^(+)百分比水平与健康对照组比较差异无统计学意义。结核组复诊时CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、NK细胞计数水平高于初诊时,差异有统计学意义(P<0.05);结核组复诊时CD3^(+)、NK细胞计数水平低于健康对照组,差异有统计学意义(P<0.05);结核组复诊时CD3^(+)CD4^(+)、CD3^(+)CD8^(+)与健康对照组比较差异无统计学意义;结核潜伏感染组复诊时CD3^(+)、CD3^(+)CD4^(+)、NK细胞计数水平低于初诊时,差异有统计学意义(P<0.05),CD3^(+)CD8^(+)与初诊时比较差异无统计学意义;健康对照组、结核潜伏感染组复诊时CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、NK细胞计数水平比较差异无统计学意义。结核组复诊时CD3^(+)细胞百分比水平低于初诊时,差异有统计学意义(P<0.05);其他组内组间各指标两两比较差异无统计学意义。结论肺结核、肺结核潜伏期患者存在T细胞亚群及NK细胞表达异常情况,可结合各指标变化情况进行治疗指导及预后评估。

Objective To explore the clinical study on the expression of CD3^(+),CD4^(+),CD8^(+)T cell subsets,natural killer cells(NK)in the treatment of tuberculosis.Methods Patients with active pulmonary tuberculosis(tuberculosis group),latent tuberculosis infection(latent tuberculosis infection group)and healthy controls(healthy control group)admitted to the Pingxiang Second People's Hospital from June to November 2020 were selected as the research subjects,with 30 cases in each group.Flow cytometry was used to detect the counts and percentages of CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+)and NK cells among the three groups.Results The levels of CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+)and NK cell counts in the tuberculosis group were lower than those in the latent tuberculosis infection group and the healthy control group,and the differences were statistically significant(P<0.05);the levels of CD3^(+)CD4^(+)and NK cell counts in the latent tuberculosis infection group were higher than those in the healthy control group,and the differences were statistically significant(P<0.05);there were no significant differences in the counts of CD3^(+)and CD3^(+)CD8^(+)cells between the healthy control group and the latent tuberculosis infection group.There were no significant differences in the percentage of CD3^(+)CD4^(+),CD3^(+)CD8^(+)and NK cells among the three groups;the percentage of CD3^(+)cells in the tuberculosis group was lower than that in the healthy control group and the latent tuberculosis infection group,and the differences were statistically significant(P<0.05);there was no significant difference in the percentage of CD3^(+)between the latent tuberculosis infection group and the healthy control group.The levels of CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+)and NK cell counts at the follow up diagnosis in the tuberculosis group were higher than those at the initial diagnosis,and the differences were statistically significant(P<0.05).The levels of CD3^(+)and NK cell counts at the follow up diagnosis in the tuberculosis group were lower than those in the healthy control group,and the differences were statistically significant(P<0.05);there were no significant differences in CD3^(+)CD4^(+)and CD3^(+)CD8^(+)at the follow up diagnosis between the tuberculosis group and the healthy control group,the levels of CD3^(+),CD3^(+)CD4^(+)and NK cells at the follow up diagnosis in the latent tuberculosis infection group were lower than those at the initial diagnosis,and the differences were statistically significant(P<0.05),there was no significant difference in CD3^(+)CD8^(+)compared with the initial diagnosis;there were no significant differences in the levels of CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+)and NK cell counts between at the follow up diagnosis the healthy control group and the latent tuberculosis infection group.The percentage of CD3^(+)cells at the follow up diagnosis in the tuberculosis group was lower than that in the initial diagnosis,and the difference was statistically significant(P<0.05);there was no significant difference in each index between the other groups.Conclusion Patients with pulmonary tuberculosis and latent tuberculosis have abnormal T cell subpopulations and NK cell expression,and treatment guidance and prognosis evaluation can be based on changes in their indicators.