重症肺结核患者T细胞免疫球蛋白黏蛋白分子的表达及其预后意义

目的 探讨重症肺结核患者T淋巴细胞亚群、T细胞免疫球蛋白黏蛋白分子(TIM-1,TIM-3)的表达及其预后意义。方法 回顾性分析2019年1月至2021年6月在我院收治的1 056例重症肺结核患者为研究对象,并将其定义为重症肺结核组,另选同期在我院进行治疗的1 000名轻症肺结核患者作为轻症肺结核组。比较两组患者TIM-1、TIM-3以及外周血T细胞亚群(CD4⁺、CD8⁺)水平;检测并比较外周血单个核细胞中TIM-1、TIM-3的mRNA水平;分析重症肺结核患者外周血T细胞亚群、TIM-1、TIM-3与患者预后的关系。结果 重症肺结核组CD8⁺、TIM-1和TIM-3水平均高于轻症肺结核组,CD4⁺水平低于轻症肺结核组(均P<0.001)。重症肺结核组TIM-1 mRNA和TIM-3 mRNA水平均高于轻症肺结核组(均P<0.001)。死亡组CD8⁺、TIM-1和TIM-3水平均高于存活组,CD4⁺水平低于存活组(均P<0.001)。相关性分析发现:存活组患者TIM-1、TIM-3与CD4⁺均呈负相关(r值分别为-0.114和-0.211,P<0.05),而与CD8⁺均呈正相关(r值分别为0.571和0.680,P<0.05)。结论 重症肺结核患者免疫功能紊乱可能与其体内外周血T细胞亚群水平异常以及TIM-1、TIM-3 表达水平升高有关。

Expression and prognostic value of T cell immunoglobulin mucin in patients with severe pulmonary tuberculosis

This study aimed to investigate the expression and prognostic value of T lymphocyte subsets, T cell immunoglobulin mucin molecule (TIM-1 and TIM-3) in patients with severe pulmonary tuberculosis. A total of 1 056 patients with severe pulmonary tuberculosis treated in our hospital from January 2019 to June 2021 were analyzed retrospectively and defined as the severe pulmonary tuberculosis group. A total of 1 000 patients with mild pulmonary tuberculosis treated in our hospital in the same period were selected as the mild pulmonary tuberculosis group. The levels of TIM-1, TIM-3 and peripheral blood T cell subsets (CD4⁺ and CD8⁺) were compared between groups. The mRNA levels of TIM-1 and TIM-3 in peripheral blood mononuclear cells were detected and compared. The relationships among TIM-1, TIM-3 and peripheral blood T cell subsets and prognosis in patients with severe pulmonary tuberculosis were assessed. The levels of CD8⁺, TIM-1 and TIM-3 in the severe pulmonary tuberculosis group were higher than those in the mild pulmonary tuberculosis group, and the level of CD4⁺ was lower than that in the mild pulmonary tuberculosis group (all P<0.001). The levels of TIM-1 mRNA and TIM-3 mRNA in the severe pulmonary tuberculosis group were higher than those in the mild pulmonary tuberculosis group (all P<0.001). The levels of CD8⁺, TIM-1 and TIM-3 in the death group were higher than those in the survival group, and the level of CD4⁺ was lower than that in the survival group (all P<0.001). TIM-1 and TIM-3 were negatively correlated with CD4⁺ (r=-0.114, r=-0.211, P<0.05) but positively correlated with CD8⁺ (r=0.571, r=0.680, P<0.05). The immune dysfunction in patients with severe pulmonary tuberculosis may be related to the abnormal levels of T cell subsets in peripheral blood and the elevated expression of TIM-1 and TIM-3.