肺结核患者支气管肺泡灌洗液中T淋巴细胞亚群的检测及其临床意义

目的　探讨肺结核患者支气管肺泡灌洗液(BALF)中T淋巴细胞亚群的特点及其临床意义。方法 采用酶联免疫分析法同时检测48例活动性肺结核及19例非活动性肺结核患者BALF及外周血中T淋巴细胞亚群。结果 活动性肺结核组BALF及外周血中CD₄T细胞、CD₄/CD₈T细胞比值均明显低于非活动性肺结核组(P<0.01)。活动性肺结核患者BALF中CD₈T细胞水平明显高于外周血(P<0.05)。空洞性肺结核组BALF及外周血中CD₄/CD₈T细胞比值明显低于非空洞组。抗结核治疗2个月末BALF及外周血中CD₄T细胞、CD₄/CD₈T细胞比值均明显升高,而BALF中CD₈T细胞水平较治疗前降低(P<0.05)。结论 BALF及外周血中T淋巴细胞亚群的检测有助于判断病情、了解抗结核治疗效果及预后。

Detection and its clinical value of T lymphocyte subsets in bronchoalveolar lavage fluid in patients with pulmonary tuberculosis

Objective To assess the characteristic and its clinical value of T lymphocyte subsets in bronchoalveolar lavage fluid(BALF) in patients with pulmonary tuberculosis. Methods T lymphocyte subsets were measured by ELISA assay in BALF and peripheral blood of patients with pulmonary tuberculosis.48 cases were active tuberculosis.19 cases were inactive tuberculosis. Results CD₄ T lymphocytes and CD₄/CD₈ ratios were found in greatly depleted numbers in BALF and peripheral blood in active tuberculosis,there was statistically significant difference when compared with inactive tuberculosis( P<0.01).CD₈ T lymphocytes in active tuberculosis patients were high in BALF than in peripheral blood(P<0.05). CD₄/CD₈ ratios in BALF and peripheral blood were lower in cavitary tuberculosis than non-cavitary tuberculosis. After 2 months’ effective antituberculosis treatments, CD₄ T lymphocytes and CD₄/CD₈ ratios in BALF and peripheral blood showed a significant increase, while CD₈ T lymphocytes in BALF decreased. Conclusion Analysis of T lymphocyte subsets in BALF and peripheral blood was helpful for determining the clinical pattern of disease, recovery situation during treatment and prognosis in patients with pulmonary tuberculosis.