非耐药与耐多药肺结核患者外周血T淋巴细胞亚群及细胞因子的变化

Change in peripheral blood T lymphocyte subsets and cytokines in patients with drugsensitive and multidrugresistant pulmonary tuberculosis

摘要:

目的对非耐药(DS)及耐多药(MDR)肺结核患者外周血T淋巴细胞亚群及细胞因子的变化及意义进行探讨。方法 对某医院及某结核病防治所2011年7月—2012年7月住院的肺结核患者（其中DS肺结核患者20例，MDR肺结核患者15例）以及医院同期26例健康体检者（对照组）外周血的CD3+、CD4+、CD8+T淋巴细胞亚群进行检测；同时检测外周血干扰素（IFN）γ、白细胞介素（IL）10，对3组数据进行比较。结果DS肺结核组、MDR肺结核组及对照组CD3+、CD4+、CD8+T淋巴细胞亚群的表达率比较，差异无统计学意义（P＞0.05)；3组患者CD3+、CD4+、CD8+T淋巴细胞绝对值比较，差异有统计学意义（P＜0.01）；各组间两两比较，差异亦有统计学意义（P＜0.05),其中对照组CD3+［（1 426±485）/μL］、CD4+［（825±306）/μL］、CD8+T淋巴细胞［（516±213）/μL］绝对值最高，MDR肺结核组最低［分别为（746±358）/μL、（461±204）/μL、（213±101）/μL］。3组间IFNγ浓度比较，差异有统计学意义（P＜0.01)；各组间两两比较，差异亦有统计学意义（P＜0.05)，其中对照组浓度 ［（65.04±36.31）pg/mL］最高，MDR肺结核组 ［（23.32±14.04）pg/mL］最低。3组间IL10浓度比较，差异无统计学意义（P＞0.05）。结论人类痰菌阳性肺结核及MDR肺结核患者外周血CD3+、CD4+、CD8+T淋巴细胞绝对值及血清IFNγ有不同程度下降，其下降可能促进了结核病情进展，且可能为耐药肺结核形成的原因之一。

Abstract:

ObjectiveTo evaluate the changes and significance of T lymphocyte subsets and cytokines in peripheral blood of patients with drugsensitive and multidrugresistant pulmonary tuberculosis（MDR pulmonary TB）.MethodsFrom July 2011 to July 2012, T lymphocyte subsets (CD3+,CD4+,and CD8+T)and cytokines(IFNγ and IL10) were detected in patients with drugsensitive pulmonary TB (DS group, 20 cases),MDR pulmonary TB (MDR group, 15 cases) and healthy physical examination persons (control group,26 cases) in a hospital, data of three groups were compared.ResultsNo significant differences were found in percentages of CD3+,CD4+,and CD8+T among three groups(P>0.05);there were significant differences in absolute counts of CD3+,CD4+,and CD8+T among three groups（P＜0.01）,and the difference between every two groups was also significant (P<0.05), which was highest in control group(CD3+［1 426±485］/μL;CD4+［825±306］/μL;CD8+T［516±213］/μL）and lowest in MDR group（CD3+ ［746±358］/μL；CD4+ ［461±204］/μL；CD8+T ［213±101］/μL）. There were significant differences in IFNγ value among three groups（P＜0.01）, and the difference between every two groups was also significant (P<0.05), which was highest in control group (［65.04±36.31］pg/mL) and lowest in MDR group(［23.32±14.04］pg/mL). No significant differences were found in IL10 among three groups（P＞0.05）.ConclusionThe absolute counts of T lymphocyte subsets CD3+,CD4+,and CD8+T as well as IFNγ declined in drugsensitive pulmonary TB patients and MDR pulmonary TB patients, which may accelerate the progress of TB and be one of the causes of MDR pulmonary TB.