初治骨关节结核患者外周血T细胞亚群特点及临床意义研究

目的探讨初治骨关节结核患者外周血T细胞亚群与临床指标的关系以及抗结核治疗对骨关节结核患者细胞免疫的影响。方法采用单平台流式细胞术,检测骨关节结核患者治疗前和治疗后1-2月T细胞亚群绝对数及百分比,并与恶性骨肿瘤患者和健康者比较。结果初治骨关节结核组CD4 及CD8 T细胞绝对数较健康对照组低(P<0.01)。骨关节结核患者在治疗1-2月后CD4 百分比升高(P<0.05)。脊柱结核合并脓肿组CD4/CD8比值较低,CD8 百分比较高(P<0.01)。结论初治骨关节结核患者存在细胞免疫缺陷。脊柱结核是否形成脓肿,与CD8 T细胞有关。初治骨关节结核患者经1-2月化疗后,细胞免疫状况改善,但仍处于受抑制状态。

The Characteristics and Clinical Significance of T Lymphocyte Subsets in Peripheral Blood of Initially Treated Patients with Osteoarticular Tuberculosis

Objectives To investigate the features, changes of T lymphocyte subsets in peripheral blood of initially treated cases with osteoarticular tuberculosis before and after antituberculosis treatment, and to investigate its relationship to clinical factors. Methods The absolute counts and percentages of lymphocyte subsets in patients pre-treatment and one month post-treatment were detected by single-platform flow cytometry. The data of T lymphocyte subsets in osteoarticular tuberculosis patients were compared with those in patients with malignant primary or metastatic bone tumor and normal controls. Results The absolute counts of CD4 and CD8 T lymphocyte in osteoarticular tuberculosis patients were significantly lower than that of those in normal controls and with malignant bone tumor patients(P<0.01). The percentages of CD8 T lymphocytes and the CD4/CD8 ratio in spinal tuberculosis patients with abscesses were significantly higher than that of those without abscesses (P<0.01). The percentages of CD4 T lymphocytes were significantly higher in one month post-treatment patients than that of those in pre-treatment patients(P< 0.05). Conclusions The cell-mediated immunity in initially treated patients with osteoarticular tuberculosis presents deficiency. Whether or not an abscess is due to spinal tuberculosis patients, is correlated to CD8 T lymphocyte. The cell-mediated immunity in osteoarticular tuberculosis patients after one to two months therapy is improved.