活动性肺结核患者支气管肺泡灌洗液免疫细胞分析

目的探讨活动性肺结核患者的免疫功能状态,为临床免疫治疗提供理论依据。方法收集活动性肺结核患者35例,并根据年龄、镜下分型和支气管CT评分对上述患者进行分组,同期选择12例健康志愿者作为健康对照组,分析两组研究对象支气管肺泡灌洗液T细胞、CD4细胞、CD8细胞、单核细胞和B细胞比例的差异。结果活动性肺结核患者的CD4细胞和CD8细胞的比例分别为(54.76±17.44)%和(41.24±15.65)%,与健康对照组的(65.43±10.00)%和(32.3±8.69)%比较,差异均无统计学意义(P>0.05)。活动性肺结核组单核细胞比例(9.38±8.1)%高于健康对照组(2.15±2.52)%,差异有统计学意义(P<0.05)。与健康对照者相比,炎性浸润型患者和瘢痕狭窄型患者的CD4细胞比例降低,CD8细胞比例升高,CD4细胞/CD8细胞降低,且具有统计学意义(P<0.05),另外,炎性浸润型患者的单核细胞高于健康对照者(P<0.05)。溃疡坏死型患者的单核细胞和B细胞均高于健康对照者(P<0.05);CT评分高的组单核细胞比例显著高于低CT评分组(P<0.05)。结论支气管肺泡灌洗液免疫细胞水平的检测有助于阐明肺结核的免疫致病机理,同时也可为临床免疫治疗提供理论依据。

Analysis of immunocyte levels in bronchoalveolar lavage fluid of patients with pulmonary tuberculosis

Objective To study the immune state of patients with active pulmonary tuberculosis, and to provide theoretical basis for clinical immunotherapy. Methods Thirty-five patients with active tuberculosis were recruited and grouped according to age, bronchial tuberculosis types and bronchial CT score. At the same time, 12 healthy individuals were selected as the control group. The proportion of T cells, CD4 cells, CD8 cells, monocytes and B cells in the bronchoalveolar lavage fluid of above 47 individuals were statistically analyzed. Results The proportions of CD4 cells and CD8 cells in active pulmonary tuberculosis patients were (54.76±17.44)% and (41.24±15.65)%, respectively. The differences were not statistically significant (P>0.05) compared with those in healthy control group (65.43±10.00)% and (32.3±8.69)%. The percentage of monocytes in active pulmonary tuberculosis group (9.38±8.1)% was higher than that in healthy control group (2.15±2.52)% (P<0.05). Compared with healthy individuals, patients with inflammatory infiltration and scar stenosis had lower CD4 cells proportion and the percentage of CD4 cells/CD8 cells (P<0.05), but the proportion of CD8 cells increased significantly (P<0.05). In addition, the proportion of monocytes in patients with inflammatory infiltration was higher than those healthy individuals (P<0.05). The proportion of monocytes and B cells in patients with ulcer necrosis was higher than those healthy individuals (P<0.05). The proportion of monocytes in the group with high CT score was significantly higher than those in the low CT score group (P<0.05). Conclusion The detection of immunocyte levels in bronchoalveolar lavage fluid contributes to elucidate the immunogenic pathogenesis of tuberculosis and provides theoretical basis for clinical immunotherapy.