Distribution of natural killer cells and T-lymphocyte subsets in peripheral blood,gallbladder cancer and surrounding tissue

BACKGROUND: The patient with malignant tumor always show immunologic function drawback and ingravescent with tumor development, especially in the aspect of cell-mediated immunity. This study was undertaken to define the relationship between the immune function of local cells and cancer development by investigating the distribution of natural killer (NK) cells and T-lymphocyte subsets in peripheral blood, the cancer tissue and the tissue surrounding gallbladder carcinoma. METHODS: The numbers of CD4(+) and CD8(+) T-lymphocytes and NK cells were measured by flow cytometry in samples taken from gallbladder cancer tissue, the surrounding tissues and peripheral blood of 38 patients, and compared with the numbers in the peripheral blood and gallbladder tissue of 30 patients with cholecystitis as controls. RESULTS: The numbers of CD4(+) and CD8(+) T-cells and NK cells in gallbladder cancer tissues were significantly higher than those in the surrounding tissue and gallbladder with gallstone. However, the ratio of CD4(+)/CD8(+) was lower in the cancer tissue than that in the surrounding tissue and tissue from gallbladders with gallstones. The distribution of CD4(+) and CD8(+) T-cells and NK cells in mucous membrane of cholecystitis gallbladder and that in the tissue surrounding gallbladder cancer were significantly different. CONCLUSIONS: Disproportionate and imbalanced distribution of NK cells and subsets of T-lymphocytes occurs in the mucous membrane proper of gallbladder cancer and surrounding tissue. Although gallbladder cancer tissue has higher expressions of CD4(+), CD8(+) and NK cells, the immune function is low or in an inhibited state. In gallbladder cancer immunization therapy, local cellular immunological function should be enhanced and the protective barrier improved.

Effects of Intraoperative Administration of Dexmedetomidine on the Percentage of T-Lymphocyte Subsets and Natural Killer Cells in Patients with Colorectal Cancer

Study Objective: To observe the effect of dexmedetomidine (DEX) on T-lymphocyte subsets and natural killer (NK) cells in the peripheral blood of perioperative patients with colorectal cancer. Design: A random double-blind control clinical study. Setting: A university hospital. Patients: Forty patients with colorectal cancer, ASA I-П. Interventions: All patients were randomly divided into a DEX group (n = 20) and a control group (n = 20). Before induction of anesthesia, epidural catheters were placed in the L1-L2 or T12-L1 intervertebral spaces. The DEX group received 1 μg/kg of DEX (200 μg/50 ml) intravenously for 15 min prior to the surgery, which was then infused at a rate of 0.5 μg/kg/h until 30 min before the end of the surgery. The control group received an intravenous infusion of saline (50 ml) instead of DEX during the same periods as the DEX group. All patients received routine anesthesia and postoperative analgesia. Measurements: Blood samples from all patients were collected at the following time points: before anesthesia (T0), 24 h after surgery (T1), 48 h after surgery (T2) and 72 h after surgery (T3). Changes in T-lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and NK cells were determined by flow cytometry. Main Results: Compared with the control group, the percentages of CD3+ and CD4+ cells and the CD4+/CD8+ ratio in the DEX group increased significantly from T1 to T3

The peri-operative changes of T-lymphocyte subsets in the elder esophageal carcinoma patients

Objective:The aim of the study was to observe and compare the trend of T-lymphocyte subsets in the elder and adult esophageal carcinoma patients postoperatively. Methods: Forty-four esophageal carcinoma patients, classified as ASA physical status I-II, were divided into two groups. Twenty-two patients aged than 65 years were grouped as elder patient group, and the rest twenty-two patients, served as adult patient group, were younger than 60 years old. The jugular venous blood samples were collected before induction of anesthesia (T1) as baseline, after completion of surgery (T2), on the first, second and fifth postoperative days (T3, T4 and T5), respectively. The blood counts of CD3+, CD4+ and CD8+T-lymphocyte were measured by flow cytometer. Results: Compared with the baseline level, the blood CD3+, CD4+ and CD4/CD8 levels were significantly decreased immediately after surgery, on the first and second postoperative days in the two groups (P<0.01), which returned to baseline values on the fifth postoperative day (P>0.05). On the fifth postoperative day, CD3+, CD4+ and CD4/CD8 levels in adult group were significantly higher than those in elder group (P<0.05). Conclusion: The postoperative immune function in elder patients recovered more slowly than that in adult.

Effects of Heat Clearing and Stasis Resolving Method on PTS,Inflammatory Factors and T-lymphocyte Subsets in Peripheral Blood of URM Patients with Suppressed Internal Heat

[Objectives]To explore the effects of heat clearing and stasis resolving method on prethrombotic state,inflammatory factors and T-lymphocyte subsets in peripheral blood of unexplained recurrent miscarriage(URM)patients with suppressed internal heat.[Methods]Thirty cases of URM patients with suppressed internal heat and 30 normal women were collected,and characteristics of changes in peripheral serum D-dimer(D-D),fibrin degradation product(FDP),fibrinogen(FIB),IL-6,IL-10 and TNF-α,CD,CD,CD,CD,CDlevels were detected.URM patients were treated with traditional Chinese medicine for clearing heat and resolving blood stasis for 3 menstrual cycles,and the changes of indicators before and after treatment were observed.[Results]Compared with normal women,the peripheral serum levels of D-D,IL-6,TNF-αand CDin URM patients with suppressed internal heat were increased(P<0.05),while the IL-10 lymphocyte level was significantly decreased(P<0.05);compared with that before treatment,the contents of D-D,IL-6,TNF-αand CDdecreased after 3 menstrual cycles(P<0.05),while the contents of IL-10 and CDT lymphocytes increased significantly(P<0.05).[Conclusions]The heat clearing heat and stasis resolving method can effectively improve the prethrombotic state of URM,and the action mechanism may be related to the regulation of immune and peripheral blood inflammatory factors.

Effects of Radiofrequency Ablation on Lymphocyte Subsets and Type 1/Type 2 T Cell Subpopulations in Patients with Hepatocellular Carcinoma

Objective： To evaluate whether radiofrequency ablation （RFA） might have an influence on immune status in hepatocellular carcinoma （HCC） patients. Methods： We measured the T lymphocytes, B lymphocyte and NK cells, and determined the population of Thl, Th2, Tcl and Tc2 of peripheral blood samples taken from 26 HCC patients before and after RFA. Results： The proportion of Typel cells （Thl and Tcl） and NK cells were significantly increased after RFA, especially in patients of the following subgroups： male, age〉55 years, pathological grade Ⅰ-Ⅱ tumor, clinical stage Ⅰ-Ⅱ or Child-Pugh A and B. Conclusion： TypeⅠ cells and NK cells in HCC patients were increased in a short period after RFA.

mIL-2R,T cell subsets & hepatitis C

AIM: To study the levels of membrane interleukin-2 receptor (mIL-2R) and T cell subsets in peripheral blood mononuclear cells (PBMC) from patients with hepatitis C and their role in the pathogenesis of hepatitis C. METHODS: The levels of mIL-2R and T cells subsets in PBMC were detected by biotin- streptatividin (BSA) technique before and after stimulation with PHA in 203 patients with hepatitis C with HCV-RNA(+), anti-HCV(+), anti-HCV(-). RESULTS: The total expressive levels of mIL-2R before and after stimulation with PHA(0.03+/-0.01, 0.03+/-0.02, 0.04+/-0.02, 0.36+/-0.03), and T cell subsets in PBMC (0.62+/-0.06, 0.37+/-0.05, 0.35+/-0.07) were all lower in patients with hepatitis C than those in normal controls (0.66+/-0.07, 0.41+/-0.06, 0.31+/-0.05, P【0.01). Among the patients, the levels of mIL-2R were lower in silence than those in situation of PHA inducting (P【0.01). However, the levels of mIL-2R were similar in acute hepatitis C to that in chronic hepatitis C (P】0.05). The levels of CD(3)(+), CD(4)(+), CD(4)(+)/CD(8)(+) were lower and CD(8)(+) was higher in patients with acute and chronic hepatitis C with anti-HCV(+) than those in normal controls (0.62+/-0.06, 0.37+/-0.05, 0.35+/-0.07, 1.18+/-0.30, 0.61+/-0.07, 0.37+/-0.05, 1.39+/-0.33, 0.31+/-0.05, P【0.05-P【0.01). CONCLUSION: The cellular immunity is obviously changed in patients with hepatitis C. The levels of mIL-2R and activation of T cells are closely associated with chronicity of hepatitis C.

Changes in T lymphocyte subsets after severe traumatic brain injury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.

STUDY OF T－LYMPHOCYTE SUBSETS AND INTERLEUKIN－2 AND INTERLEUKIN－2 RECEPTOR OF RESPIRATORY SYNCYTIAL VIRUS PNEUMONIA

T-Lymphocyte subsets and humoral immune and the activity of IL-2 and IL-2R in respiratory syncytial virus (RSV) pneumonia in 26 cases were tested. The result showed in the patients with RSV pneumonia the averages of T3 and T4 were 37.56±1.46% and 27. 15±8. 02% respectively,They were significantly lower than 53.4 ±9.2% and 35.5±7.7% of averages of T3 and T4 in healthy controlled group (both. P< 0. 001 ), the average of T3 was 22. 73±7.06%, it was lower an 26. 7±6. 3 % of T8 in controlled group (P<0. 02 );the ratio of T4/T8 was 1. 245±0. 399 ,there was no significant difference from 1. 35 ±0. 17 of the ratio in controlled group (P > 0. 1). The mean value of IgG was 1. 177± 0. 3685g/L, it was significantly lower than 1. 427± 0. 498g/L of that in controlled group(P < 0. 005). The mean values of IgA and IgM were 0. 1136±0.0393g/L and 0. 768±0. 353g/L respectively, they were significantly lower than 0. 2706 ±0. 876g/L and 0. 122±0. 061g/L of IgA and IgM in controlled group. The activity of IL-2 and IL-2R were 17. 46 ±5. 79%, and 28. 32 ±5. 924% respectively, they were significantly lower than 30. 22 ±14. 55% and 39. 53±8. 61 % of those in healthy group (both P < 0. 001). The severe the pneuumonia, the greater the lowering of IL-2 and IL-2R. These about results suggested that RSV could greatly suppress the immune function of the patients, inducing secondary immunodeficiency, leading to repeated breather and asthma.

超声结合检验指标评价不同放疗方式对肺癌患者淋巴细胞亚群的影响

目的探索不同调强放疗方式H-alfentanil区差异对原发性肺癌患者围放疗期外周血淋巴细胞亚群的影响。方法选取2021年8月至2023年1月于河北北方学院附属第一医院放疗科行放疗的原发性肺癌患者58例,根据放疗方式不同分为IMRT组(n=28)、VMAT组(n=30);记录2组患者放疗计划参数;选定放疗前1周内(T0)、放疗剂量至40Gy时(T1)、放疗结束后4周(T2)3个时间点进行外周血淋巴细胞和亚群化验及超声检查锁骨上淋巴结及颈部淋巴结。结果治疗前VMAT组双肺V5、V10、V15、V20、V25、V30高于IMRT组,MLD低于IMRT组,差异均有统计学意义(P<0.05),治疗前PTV、2组淋巴细胞亚群各指标比较差异均无统计学意义(P>0.05);治疗后2组的淋巴细胞总数、CD3^(+)T总数、CD3^(+)CD4^(+)T亚群、CD4^(+)/CD8^(+)均降低(P<0.01);CD3^(+)CD8^(+)T亚群、CD16^(+)CD56^(+)NK亚群均升高(P<0.01);其中VMAT组CD3^(+)CD4^(+)T亚群指标、CD4^(+)/CD8^(+)指标低于IMRT组(P<0.05);Logistic分析,2组患者淋巴细胞总数的下降与双肺V5、V10、V15、V35、V40、V45、V50、V60呈正相关(P<0.05);超声检查锁骨上淋巴结及颈部淋巴结大小、形态及淋巴门的位置比较,差异无统计学意义(P>0.05)。结论原发性肺癌行IMRT、VMAT放疗均引起外周血淋巴细胞减少及淋巴细胞亚群再分布,VMAT放疗双肺H-alfentanil区较IMRT范围更大,外周血淋巴细胞减低越明显,超声的形态学检查在评价不同放疗方式对肺癌患者淋巴细胞亚群的影响的作用有限。

腹腔镜下卵巢囊肿剔除术对患者卵巢功能、炎症因子及T淋巴细胞亚群水平的影响

【目的】探讨腹腔镜下卵巢囊肿剔除术对患者卵巢功能、炎症因子及T淋巴细胞亚群水平的影响。【方法】选取2019年1月至2023年1月本院妇科收治的76例卵巢囊肿患者,根据手术方法不同分为对照组和观察组,每组38例。对照组行开腹卵巢囊肿剔除术治疗,观察组行腹腔镜下卵巢囊肿剔除术治疗,比较两组手术前后卵巢功能[雌二醇(E 2)、促卵泡激素(FSH)、黄体生成素(LH)]、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]及T淋巴细胞亚群水平(CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+))。【结果】两组术后3个月FSH、LH均升高,但观察组低于对照组(P<0.05);两组术后3个月E 2均降低,但观察组高于对照组(P<0.05)。观察组患者术后IL-6、TNF-α、CRP水平低于对照组,差异有统计学意义(P<0.05)。两组患者术前CD4^(+)、CD4^(+)/CD8^(+)比较,差异无统计学意义(P>0.05);术后1 d,两组患者血清CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较术前明显降低,但观察组高于对照组,差异均有统计学意义(P<0.05);观察组患者术后3 d血清CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)恢复至术前水平。【结论】腹腔镜下卵巢囊肿剔除术可有效促进患者卵巢功能恢复,并减轻机体炎症反应,提高T淋巴细胞亚群水平,减轻对机体细胞免疫功能的抑制,有利于患者术后康复。

结核T细胞斑点试验联合外周血T淋巴细胞亚群检测在临床诊断中的价值

目的探讨结核T细胞斑点试验(T-SPOT.TB)联合外周血T淋巴细胞亚群检测在结核患者中的诊断价值。方法回顾性分析本院就诊的279例患者的临床资料。依据诊断标准分为结核组147例、非结核组132例,评估T-SPOT.TB与外周血T淋巴细胞亚群检测对结核病的诊断价值。结果结核组T-SPOT.TB阳性率高于非结核组(P<0.01);肺结核组患者CD3^(+)、CD4^(+)及CD8^(+)较非结核组相比有下降(P<0.05),CD4^(+)/CD8^(+)较非结核组变化不明显(P>0.05);两者联合检测受试者工作特征曲线下面积(AUC)为0.354(P<0.01),灵敏度90.48%,特异性38.64%,约登指数为0.291。结论T-SPOT.TB和外周血T淋巴细胞亚群检测诊断肺结核具有较高灵敏度,但在对结核和非结核的鉴别诊断中特异性降低,在临床中对结核的诊断价值有一定的意义,是对肺结核诊断的有效补充。

驱梅汤联合多西环素对梅毒患者免疫炎症反应及外周血单核细胞TLR2、Foxp3 mRNA的影响

目的探讨驱梅汤联合多西环素对梅毒患者免疫炎症反应及外周血单核细胞(PBMCs)Toll样受体2(TLR2)、叉头框蛋白3(Foxp3)mRNA水平的影响。方法选取2016年12月至2020年12月邢台市第二医院收治的107例梅毒患者作为研究对象。采用随机信封法分为常规组(n=53)和实验组(n=54)。常规组采用多西环素治疗,实验组采用多西环素联合驱梅汤治疗。比较两组梅毒滴度快速血浆反应素试验(RPR)转阴率、临床疗效、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、PBMCs TLR2、Foxp3 mRNA相对表达量及不良反应发生情况。结果实验组治疗后3、6个月RPR转阴率高于常规组(P<0.05);实验组总有效率高于常规组(P<0.05);治疗30 d后实验组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于常规组(P<0.05);治疗30 d后实验组PBMCs TLR2、Foxp3 mRNA相对表达量低于常规组(P<0.05);实验组不良反应发生率低于常规组(P<0.05)。结论驱梅汤联合多西环素治疗梅毒患者能提高转阴率,疗效确切,且安全性较高,这可能与抑制PBMCs TLR2、Foxp3 mRNA表达有关。

Endothelial function and T-lymphocyte subsets in patients with overlap syndrome of chronic obstructive pulmonary disease and obstructive sleep apnea

Background:The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is termed overlap syndrome (OS).COPD and OSA both have increased risks of developing cardiovascular diseases.This study aimed to explore if patients with OS exhibited a higher prevalence of cardiovascular complications,and if patients with OS exhibited vascular endothelial dysfunction and abnormalities in the cellular immune function of T lymphocytes.Methods:Totally 25 patients with stable COPD (COPD group),25 patients with OSA (OSA group),25 patients with OS (OS group),and 20 healthy adults (control group) were enrolled between January 2017 and December 2017 from the Respiratory Department of Tianjin Medical University General Hospital.The clinical characteristics of the four groups were collected and the expression levels of soluble vascular cell adhesion molecule-1 (sVCAM-1),tumor necrosis factor-α(TNF-α),and T-lymphocyte subsets were detected.One-way analysis of variance,x^2 test and Pearson correlation were used to manage the data.Results:The prevalence of hypertension and coronary heart disease was significantly higher in the OS group than in the control,OSA,and COPD groups (x^2 =20.69,P < 0.05 and x^2 =11.03,P < 0.05,respectively).The levels of sVCAM-1 and TNF-α were significantly higher in the OS group than in other groups (F =127.40,P < 0.05 and F =846.77,P < 0.05,respectively).The percentage of CD4+ lymphocytes and CD4+/CD8+ were both significantly lower in the OS group than in any other group (F =25.40,P < 0.05 and F =75.08,P < 0.05,respectively).There were significantly negative correlations in the levels of sVCAM-1 and TNF-α with CD4^+/CD8^+ lymphocytes (r =-0.77,P < 0.05 and r =-0.83,P < 0.05,respectively).Conclusions:The prevalence of hypertension and coronary heart disease was higher in patients with OS than in patients with either OSA or COPD alone.Patients with OS exhibited more severe vascular endothelial injury,stronger inflammatory response,and lower cellular immune function.

Regulatory Effect of Langchuang Serial Recipes on T-Lymphocyte Subsets Th and Tc in Patients with Systemic Lupus Erythematosus

Objective： To study the principle of clearing Fei （肺）, cooling blood, and detoxification as well as nourishing yin and moisening Fei （abbr. as CCD-NM） in regulating the levels of peripheral T-lymphocyte subsets Th and Tc cells to explore its mechanism for lowering the incidence of infection in patients with systemic lupus erythematosus iSLE）. Methods： Sixty SLE patients without complicated infection were assigned to the treatment group and the control group, 30 in each group. The control group was treated with Western medicine alone, while the treatment group was treated with the same program of Western medicine, but additionally administered with either Langchuang No.1 （狼疮 Ⅰ号） or 2 （狼疮 Ⅱ 号）, serial concerted Chinese recipes, applied respectively in patients in the active stage or in the resting stage. The total time of treatment for both groups was 1 year. Further, a healthy control group was set up with 20 healthy subjects. The expressions of Thl, Th2, and Tcl and Tc2 cells in peripheral blood were detected and compared with those in the healthy control group. Results： （1） As compared with the healthy control group, ratios of Thl/Th2 and Tcl/Tc2 in SLE patients, whether complicated with infection or not, were significantly lower （P〈0.05 or P〈0.01）. （2） Comparison between patients with complications and those uncomplicated with infection showed that the two ratios and Thl expression were lower and Tc2 was higher in the former than those in the latter （all P〈0.05）. （3） Ratios of Thl/Th2 and Tcl/Tc2 increased after treatment in patients of both the treatment group and the control group （P〈0.05 and P〈0.01）, but the changes in the treatment group were more significant （P〈0.05）. Conclusion： The principle of CCD-NM could regulate the Th and Tc subsets toward equilibrium in SLE patients, which might be one of the mechanisms of action for alleviating complicated infection.

Clinical characteristics and T-lymphocyte subsets in 48 acquired immune deficiency syndrome patients with cytomegalovirus infections

Objective To investigate the clinical features and Tlymphocytes subsets in patients with acquired immunedeficiency syndrome ( AIDS ) and cytomegalovirus(CMV) infection. Methods A total of 48 hospitalizedpatients with human immunodeficiency virus (HIV)-1 /AIDS and CMV infections were recruited at Peking UnionMedical College Hospital from Jan 2010 to Aug 2017.Their clinical features and immune function were retrospectivelyanalyzed. Patients with only HIV/AIDS inprevious study were recruited as controls. Results All 48patients were at C3 stage, including 36 men and12 women. Five of them were younger than 30 years old,33 cases within 31 - 50 years old,and 10 cases olderthan 50 years old.

哮喘患儿外周血T淋巴细胞亚群、IL-5、IL-25水平变化及其与ACT评分的相关性研究

目的 观察哮喘患儿外周血T淋巴细胞亚群、白介素-5 (IL-5)、白介素-25 (IL-25)水平,并分析其与哮喘控制测试评分表(ACT)评分的关系。方法 选取2017年5月至2020年6月宝鸡市人民医院收治的115例哮喘患儿作为观察组,依据患儿的临床表现分为缓解期组47例与急性发作期组68例,另选取同期在我院体检的50例健康儿童为对照组,检测两组儿童外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、IL-5及IL-25水平,采取ACT问卷调查患儿哮喘控制情况,并使用Pearson相关性检验法分析患儿T淋巴细胞亚群、IL-5、IL-25水平与ACT评分相关性。结果 急性发作期组患儿的CD8^(+)为(37.02±5.24)%,明显低于缓解期组的(40.19±6.23)%和对照组的(43.05±5.03)%,缓解期组又明显低于对照组,差异均有统计学意义(P<0.05);急性发作期组患儿的CD4^(+)、CD4^(+)/CD8^(+)分别为(54.78±7.06)%、1.57±0.28,明显高于缓解期组[(51.16±7.75)%、1.40±0.25]和对照组[(47.61±5.02)%、1.18±0.17],缓解期组又明显高于对照组,差异均有统计学意义(P<0.05);急性发作期组患儿的IL-5、IL-25分别为(74.92±12.13) pg/mL、(57.24±8.96) pg/mL,明显高于缓解期组[(67.38±10.54) pg/mL、(48.73±8.05) pg/mL]和对照组[(50.86±9.85) pg/mL、(44.68±7.12) pg/mL],缓解期组又明显高于对照组,差异均有统计学意义(P<0.05);急性发作期组患儿的ACT评分为(16.15±2.76)分,明显低于缓解期组的(20.84±2.37)分,差异有统计学意义(P<0.05);经Pearson相关性分析结果显示,CD8^(+)与ACT评分呈显著正相关(P<0.05),CD4^(+)、CD4^(+)/CD8^(+)、IL-5、IL-25与ACT评分呈显著负相关(P<0.05)。结论 哮喘患儿存在外周血T淋巴细胞亚群失衡、IL-5与IL-25表达水平异常升高,急性发作期变化更显著,CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、IL-5、IL-25水平均与ACT评分密切相关,可用于评估哮喘患儿病情。

外周血CD8^(+)T淋巴细胞亚群检测对过敏性鼻炎临床疗效的评估价值

目的探讨外周血CD8^(+)T淋巴细胞亚群检测对过敏性鼻炎(AR)临床疗效的评估价值。方法前瞻性选取2021年3月~2022年2月温州市中西医结合医院耳鼻咽喉科门诊治疗的120例AR患者和40例健康志愿者,分别设为研究组和对照组,比较两组外周血CD8^(+)T细胞、CD8^(+)CD28^(+)T细胞、CD8^(+)CD28-T细胞比率;研究组接受鼻用激素联合口服抗组胺药物治疗方案,根据治疗效果分为有效组(n=107)和无效组(n=13),比较有效组和无效组治疗前CD8^(+)T细胞、CD8^(+)CD28^(+)T细胞、CD8^(+)CD28-T细胞比率;Pearson相关性分析法分析外周血CD8^(+)T淋巴细胞亚群水平与鼻部症状总评分(totalnose symptomscore,TNSS)的相关性;以受试者工作特征(ROC)曲线分析治疗前CD8^(+)T淋巴细胞亚群对AR临床疗效的预测价值。结果研究组治疗前外周血CD8^(+)CD28^(+)T细胞比率高于对照组,CD8^(+)CD28-T细胞比率低于对照组(P<0.05)。研究组总有效率为89.17%;有效组治疗前CD8^(+)CD28^(+)T细胞比率低于无效组,CD8^(+)CD28-T细胞比率高于无效组(P<0.05);Pearson相关性分析显示,CD8^(+)CD28^(+)T细胞比率与TNSS评分呈正相关(r=0.324,P=0.006),CD8^(+)CD28-T细胞比率与TNSS评分呈负相关(r=-0.541,P=0.000)。ROC曲线结果显示,CD8^(+)T细胞、CD8^(+)CD28^(+)T细胞、CD8^(+)CD28-T细胞比率评估AR治疗无效的曲线下面积(AUC)(95%CI)分别为0.647(0.555~0.732)、0.683(0.592~0.765)、0.911(0.845~0.955),其中CD8^(+)CD28-T细胞的评估效能优于CD8^(+)T细胞、CD8^(+)CD28^(+)T细胞比率(P<0.05)。结论AR患者外周血CD8^(+)CD28^(+)T细胞比率升高,CD8^(+)CD28-T细胞比率降低,CD8^(+)T细胞比率相对稳定,治疗前CD8^(+)CD28-T细胞比率可作为预测AR患者的临床疗效的参考指标。

腺样体肥大患儿机体免疫功能变化研究

<正>腺样体也称咽扁桃体或增殖体,属于淋巴组织,表面呈桔瓣样。正常生理情况下,儿童6~7岁时腺样体发育至最大,青春期后逐渐萎缩,成人后基本消失~[1]。腺样体位于鼻咽顶后壁处,病理性肥大易引起鼻堵、张口呼吸、耳闷、听力下降等症状,最终造成慢性鼻-鼻窦炎、阻塞性睡眠呼吸暂停低通气综合征及分泌性中耳炎等疾病,给儿童的颌面骨发育、智力发育造成严重影响。

湿疹的皮肤试验及细胞免疫功能的观察

目的：确定湿疹可能的变应原，探讨细胞免疫在本病中的作用。方法：对７０例湿疹患者进行了斑贴试验，其中４１例进行了吸入变应原皮内试验，２５例进行了外周血Ｔ细胞亚群的测定。结果：斑贴试验阳性反应者６０例（８５．７１％），全部阳性１０例（１４．２８％）。阳性率较高的为重铬酸钾、对苯二胺、硫酸镍等。皮内试验阳性反应３２例（７８．０４％），阴性９例（２１．９５％），与荨麻疹组的结果相比无显著性差异。湿疹病人的Ｔ细胞亚群ＣＤ３、ＣＤ４／ＣＤ８低于正常对照组（Ｐ＜０．０１，Ｐ＜０．０５）。结论：湿疹的发生与一些常见的接触、吸入等过敏原有关，可能还与Ｔ细胞免疫功能有关。

支气管舒张试验联合T淋巴细胞亚群检测对小儿哮喘的诊断价值

目的分析支气管舒张试验(BDT)联合T淋巴细胞亚群检测对小儿哮喘的诊断价值。方法选取2020年2月—2021年2月湖南省儿童医院呼吸内科诊治的哮喘患儿73例为观察组,同期医院体检健康儿童70例为健康对照组,检测并比较2组支气管舒张试验后肺功能指标、T淋巴细胞亚群水平,分析哮喘患儿BDT改善率与T淋巴细胞亚群水平的关系,受试者工作特征曲线(ROC)评估支气管舒张试验联合T淋巴细胞亚群检测对小儿哮喘的诊断价值。结果与健康对照组比较,观察组用力呼出25%肺活量瞬间流量(FEF_(25))、FEF_(50)、FEF_(75)、最大呼气流量(PEF)、FEV_(1)、FEV_(1)/FVC值及血清CD8^(+)、CD16^(+)CD56^(+)NK水平降低(P<0.05),CD4^(+)、CD4^(+)/CD8^(+)水平升高(P<0.05);与观察组缓解期比较,急性期FEF_(25)、PEF、FEV_(1)、FEV_(1)/FVC值及血清CD8^(+)、CD16^(+)CD56^(+)NK水平降低(P<0.05),CD4^(+)、CD4^(+)/CD8^(+)水平升高(P<0.05)。急性期患儿支气管试验FEF_(25)、PEF、FEV_(1)、FEV_(1)/FVC阳性率高于缓解期(χ^(2)/P=16.385/0.001、17.648/0.001、20.367/0.001、16.529/0.01);哮喘患儿BDT改善率与血清CD8^(+)、CD16^(+)CD56^(+)NK细胞水平呈正相关(P<0.05),与血清CD4^(+)、CD4^(+)/CD8^(+)细胞水平呈负相关(P<0.05)。哮喘患儿血清CD8^(+)、CD16^(+)CD56^(+)NK、BDT改善率与病情严重程度呈负相关(r/P=-0.592/0.001、-0.634/0.001、-0.742/0.001),血清CD4^(+)、CD4^(+)/CD8^(+)细胞水平与病情严重程度呈正相关(r/P=0.617/0.001、0.611/0.001)。ROC曲线显示,BDT联合T淋巴细胞亚群检测对小儿哮喘诊断的曲线下面积(AUC)为0.966。结论支气管舒张试验、T淋巴细胞亚群联合检测,可对哮喘患儿病情严重程度作出更加准确评估,为临床疾病诊断提供有效依据,具有良好的诊断价值。