肺结核合并慢性乙型肝炎患者T淋巴细胞免疫应答研究 FREE

Immune response of T lymphocytes in patients with pulmonary tuberculosis combined with chronic hepatitis B FREE

摘要:

目的研究结核病合并慢性乙型肝炎（乙肝）患者血清中Th1型细胞的细胞因子水平变化以及Th1、Th2的表达水平及意义。方法对21例肺结核并乙肝表面抗原（HBsAg）阳性患者、30例单纯肺结核患者及30例健康对照者，应用酶联免疫吸附试验（ELISA）测定其血清中肿瘤坏死因子（TNF）α、干扰素（IFN）γ、白细胞介素（IL）12水平；运用流式细胞术检测外周血中CD4＋T淋巴细胞及细胞内Th1、Th2的表达水平。结果单纯肺结核及肺结核并HBsAg阳性组TNFα水平均显著高于健康对照组（均P＜0.01）；单纯肺结核组IFNγ、IL12水平均显著低于健康对照组（均P＜0.05），而肺结核并HBsAg阳性组IFNγ、IL12水平均显著低于单纯肺结核组（均P＜0.01）。单纯肺结核组外周血CD4＋T淋巴细胞及细胞内Th1表达水平均显著低于健康对照组（分别P＜ 0.05，P＜0.01）；细胞内Th2表达水平显著高于健康对照组（P＜0.05）。肺结核并HBsAg阳性组CD4＋T淋巴细胞及细胞内Th1表达水平显著低于单纯肺结核组(分别P＜ 0.05，P＜ 0.01)。结论肺结核患者存在细胞内Th1反应减弱，Th2反应增强；而肺结核合并慢性乙肝的患者则进一步致细胞内Th1反应减弱，Th2反应增强。

Abstract:

Immune response of T lymphocytes in patients with pulmonary tuberculosis combined with chronic hepatitis B GUO Haoyu1, LIU Hongbo2, ZHANG Chengguo1 (1 Changsha Central Hospital, Changsha 410004, China; 2 Xiangya Hospital, Central South University, Changsha 410008, China )［Abstract］ObjectiveTo study the serum levels of Th1 lymphocyte factor and the expression pattern of Th1 and Th2 in patients with pulmonary tuberculosis (PT)combined with chronic hepatitis B (CHB)．MethodsSerum levels of tumor necrosis factorα(TNFα),interferonγ(IFNγ),interleukin12 (IL12) in 21 patients with PT combined with positive HBsAg, 30 simple PT patients and 30 healthy controls were detected with enzymelinked immunosorbent assay (ELISA) ;and the expression pattern of CD4+T lymphocytes,Th1 and Th2 cells in peripheral blood were detected by flow cytometry．ResultsThe serum levels of TNFα in patients with simple PT and PT coinfected with CHB were both higher than that in healthy group (both P<0.01)；the serum levels of IFNγ and IL12 in patients with simple PT were both lower than that in healthy group (both P<0.05)；the serum levels of IFNγ and IL12 in patients with PT coinfected with CHB were both lower than that in simple PT patients (both P<0.01).The expression of CD4+ T lymphocytes and Th1 cells in simple PT patients were significantly lower than that in healthy group (P<0.05，P<0.01)；The expression of Th2 cells in simple PT patients was significantly higher than that in healthy group (P<0.05)；The expression of CD4+ T lymphocytes and Th1 cells in PT coinfected with CHB patients were significantly lower than that in simple PT patients (P<0.05，P<0.01).ConclusionPatients with PT showed lower expression of Th1 and higher expression of Th2; patients with PT coinfected with CHB showed further lower expression of Th1 and higher expression of Th2.