初治肺结核患者T淋巴细胞亚群和Th细胞的变化及与预后的关系

目的：探讨初治肺结核患者T淋巴细胞亚群和Th细胞的变化及与预后的关系。方法选取2011年1月～2013年6月在本院结核科门诊治疗的肺结核患者60例为肺结核组，按初治疗效进一步将肺结核组分为好转组与未好转组，选取健康未患肺结核30例为对照组。测定外周血T细胞亚群、Th细胞及IFN-γ、IL-4。结果治疗前，未好转组CD4^＋、CD4^＋/CD8^＋、Th1/Th2、Th1表达较对照组与好转组显著降低，Th2表达较对照组与好转组显著升高（P〈0.05）；治疗前，好转组CD4^＋、Th1/Th2、Th1表达较对照组低，Th2表达较对照组高（P〈0.05）；治疗后，好转组CD4^＋、CD4^＋/CD8^＋、Th1/Th2、Th1显著高于未好转组及治疗前，Th2显著低于未好转组及治疗前，差异有统计学意义（P〈0.05）；与治疗前比较，未好转组治疗后CD4^＋、CD8^＋、CD4^＋/CD8^＋、Th1/Th2、Th1、Th2差异无统计学意义（P〉0.05）。结论初治肺结核患者 CD4^＋、CD4^＋/CD8^＋、Th1/Th2、Th1较正常人降低，Th2较正常人升高；肺结核治疗初期，CD4^＋、CD4^＋/CD8^＋、Th1/Th2、Th1偏高，Th2偏低的患者预后较好；治疗有效后CD4^＋、CD4^＋/CD8^＋、Th1/Th2、Th1升高，Th2下降。

The change of T lymphocyte subsets and Th cells and its relationship with prognosis in the early cure tuberculosis patients

Objective To investigate the change of T lymphocyte subsets and Th cells and its relationship with prognosis in the early cure tuberculosis patients. Methods 60 patients with tuberculosis in tuberculosis outpatient clinic from January 2011 to June 2013 were selected as tuberculosis group,they were divided into improved group and non-improved group according to early cure tuberculosis curative effect.30 cases of healthy people without tuberculosis were selected as control group.Peripheral blood T cell subgroup,Th and IFN-γ,IL-4 was detected respectively. Results Be-fore treatment,CD4^＋,CD4^＋/CD8^＋,Th1/Th2,Th1 of non-improved group was significantly lower than that of control group and improved group respectively,Th2 of non-improved group was significantly higher than that of control group and im-proved group respectively （P〈0.05）.Before treatment,CD4^＋,Th1/Th2,Th1 of improved group was lower than that of control group respectively,Th2 of improved group was higher than that of control group （P〈0.05）.After treatment,CD4^＋,CD4^＋/CD8^＋, Th1/Th2,Th1 of improved group was significantly higher than that of non-improved group and before treatment respec-tively,Th2 of improved group was significantly lower than that of non-improved group and before treatment respectively, with statistical difference（P〈0.05）.CD4^＋,CD8^＋,CD4^＋/CD8^＋,Th1/Th2,Th1,Th2 of non-improved before and after treatment was compared respectively,with no statistical difference （P〉0.05）. Conclusion CD4^＋,CD4^＋/CD8^＋,Th1/Th2,Th1 of early cure tu-berculosis patient was lower than that of normal people respectively,Th2 of early cure tuberculosis patient was higher than that of normal people.Tuberculosis treatment early,CD4^＋,CD4^＋/CD8^＋,Th1/Th2,Th1 on the high side,low Th2 patient’s prognosis is good.After effective treatment,CD4^＋,CD4^＋/CD8^＋,Th1/Th2,Th1 increased,Th2 decreased.