摘要
目的探讨肺结核患者外周血CD4+CD8+T细胞(DPT)的表达、抗结核功能及其对患者预后的影响。方法采用流式细胞术检测肺结核患者和健康者外周血DPT细胞的阳性表达率,并分析其与结核病病情、复发率的相关性;通过分析其记忆表型,评估DPT细胞的抗结核免疫应答机制。结果 4组DPT阳性率差异有统计学意义(P<0.05),LSD两两比较结果提示肺结核初治组和复治组DPT阳性率最高,治愈组及对照组最低;肺结核治疗时间与DPT阳性率呈明显的负相关关系(r=-0.39,P<0.001);中枢记忆性T细胞阳性率为(32.36±11.03)%,效应记忆性T细胞(48.36±13.70)%,初始T细胞为(11.31±7.89)%,效应T细胞为(4.36±2.69)%,DPT表型以效应记忆性T细胞;Log-rank检验结果显示,DPT阳性率越高,复发的危险升高(P=0.127)。结论肺结核杆菌的感染可诱导具有抗原特异性的效应性DPT表达增高,并随着治疗时间延长逐渐下降,对评估肺结核患者的病情与预后具有一定的预测价值。
[ Objective ] To investigate the evaluation value of CD4＋CD8＋double-positive T （DPT） cells in periph- eral blood on the prognosis of patients with pulmonary tuberculosis. [ Methods ] Flow cytometry was used to detect the DPT positive rate from the peripheral blood of tuberculosis patients and healthy subjects, and TB immune re- sponse and the mechanisms of memory phenotype of DPT were analyzed. [ Results ] The D[rr positive rates of the four groups had significant difference （P 〈 0.05）, LSD results suggested that the DPT positive rate in initial treatment group and retreatment group was the highest, followed by cure and control groups; tuberculosis treatment time and DPT positive rate showed a significant negative correlation （r = -0.39, P 〈 0.001）; the positive rate of central memo- ry T cells was （32.36±11.03）%, the positive rate of effector memory T ceils was （48.36±13.70）%, the positive rate of naive T cells was （11.31 ±7.89）%, the positive rate of effector T ceils was （4.36±2.69）%. Log-rank test showed that the DIrF positive rate was increased with the risk of recurrence （P = 0.127）. [ Conclusions] Pulmonary tuberculosis infection can induce increasing expression of specific antigenic DPT and it decreases with treatment prolonging, which has some predictive values to assess the patient＇s condition and prognosis of tuberculosis.
出处
《中国现代医学杂志》
CAS
北大核心
2015年第22期50-54,共5页
China Journal of Modern Medicine
