特发性肺纤维化患者外周血单个核细胞T淋巴细胞亚群及Th1/Th2型细胞因子的检测

目的：通过流式细胞术检测特发性肺纤维化(IPF)患者外周血T淋巴细胞亚群及Th1/Th2型细胞因子水平，探讨其在IPF发病机制中的作用及临床意义。方法：采用流式细胞术检测25例IPF患者外周血单个核细胞(PBMC)的T淋巴细胞亚群(CD3⁺、CD4⁺及CD8⁺)以及Th1型细胞因子(IFN-γ)和Th2型细胞因子(IL-4)水平，并观察CD4⁺/CD8⁺和Th1/Th2比值变化。25例健康体检者为正常对照组。结果：IPF组患者CD4⁺以及CD4⁺/CD8⁺比值均低于正常对照组(P<0.05)，CD8⁺明显高于正常对照组 (P<0.01)，CD3⁺水平与正常对照组比较差异无显著性(P>0.05)。IPF组患者IL-4水平高于正常对照组(P<0.01)，IFN-γ的水平与正常对照组比较差异无显著性(P>0.05)，Th1/Th2比值显著低于正常对照组(P<0.01)。结论：细胞免疫过强和Th2型免疫优势可能参与IPF发病，这将为IPF的诊断和细胞因子治疗提供理论基础。

Determination of T lymphocytes subset and cytokine of Th1/Th2 lymphocytes in peripheral blood mononuclear cells from patients with idiopathic pulmonary fibrosis

Objective To detect T lymphocytes subset and Th1/Th2 of peripheral blood from patients with idiopathic pulmonary fibrosis(IPF) by flow cytometry(FCM) and evaluate the role of them in pathogenesis and clinical significance.Methods The levels of T lymphocyte subset(CD3+,CD4+,CD8+),IFN-γ belonged to Th1 and IL-4 belonged to Th2 in peripheral blood mononuclear cells(PBMC)were detected by FCM and the ratio of CD4+/CD8+,Th1/Th2 were analyzed from 25 patients with IPF.25 healthy volunteers were used as controls.Results The level of CD4+ and the ratio of CD4+/CD8+ in IPF group were lower than those in control group(P<0.05).The level of CD8+ in IPF group was obviously higher than that in control group(P<0.01),while CD3+ had no change(P>0.05).The level of IL-4 in IPF group was significantly higher than that in control group(P<0.01),while the level of IFN-γ had no change(P>0.05).The ratio of Th1/Th2 in IPF group was significantly lower than that in control group(P<0.01).Conclusion The excessive cell immunity and immunodominance of Th2 with disbalance of Th1/Th2 may participate in pathogenesis of IPF,which will supply rationale foundation for diagnosis and cytokine therapy of IPF.