摘要
目的探讨糖皮质激素对结核性胸腔积液T淋巴细胞特征的影响。方法将肺炎性胸腔积液患者作为对照组;结核性渗出性胸膜炎(简称:结胸)患者随机分为3组,即尚未使用任何药物组(结胸组)、单纯使用抗结核药物组(抗结核组)及抗结核药物联合使用糖皮质激素组(激素组),收集各组的胸腔积液淋巴细胞,体外培养48h后取上清液,采用酶联免疫吸附测定(ELISA)法测定不同T淋巴细胞亚群所分泌相应的细胞因子的水平改变。结果代表辅助T细胞1(Th1细胞)的γ干扰素(IFN-γ)在结胸组水平较对照组明显升高(P<0.01),而代表Th2细胞的白介素-4(IL-4)水平则较对照组有所下降(P<0.05);结核性胸膜炎的治疗过程中,激素组较抗结核组IFN-γ水平明显下降(P<0.01),而IL-4水平变化不明显(P>0.05)。结论结核性胸腔积液T淋巴细胞特征是Th1细胞优势表达,而糖皮质激素可改变这一特征,使Th1细胞优势表达受到抑制。
Objective To evaluate the effects of glucocorticoids on the T-lymphocytic characterization in tuberculous pleural effusion. Methods The lymphocytes in pleural effusion were gotten from pneumonic pleurisy (group N),patients with tuberculous pleurisy before anti-tuberculous therapy (group T),patients after simple anti-tuberculous therapy (group A),and those with anti-tuberculotics plus glucocorticoids therapy (group G) respectively. The above cells were stimulated with phytohemagglutinin(PHA),and the levels of interferon-γ(IFN-γ) secreted by T helper lymphocytes-1(Th1) and interleukin-4 (IL-4) secreted by T helper lymphocytes-2(Th2) in culture supernate of the lymphocytes were determined by ELISA after 48 h. Results The levels of IFN-γ in group T were significantly higher than those of the group N(P<0.01),but the levels of IL-4 were lower than those of the group N(P<0.05),and the levels of IFN-γ in group G were significantly lower than those of the group T(P<0.01),however the changes of the level of IL-4 showed no significant difference between group G and group T (P>0.05). Conclusion Th1 is predominant T-lymphocyte in tuberculous pleural effusion,however this characterization can be controlled by glucocorticoids.
出处
《中国药物与临床》
CAS
2005年第6期433-435,共3页
Chinese Remedies & Clinics
