重症腹腔结核患者外周血和腹水中Th17细胞及其相关因子的水平和意义

目的：通过检测重症腹腔结核患者外周血和腹水中Th17细胞及其相关因子的水平，探讨Th17细胞在重症腹腔结核疾病发展过程中的变化。方法：使用流式细胞术检测腹腔结核患者重症期、恢复期以及健康对照组外周血Th17的表达率，ELSIA法检测血清以及腹腔结核重症期、恢复期患者腹水IL-6、IL-17、IL-23水平，分析各组上述指标之间的差异以及各指标间的相关性。结果：腹腔结核重症期组患者Th17细胞所占CD4＋T细胞比率和外周血IL-6、IL-17和IL-23水平显著高于恢复期组和健康对照组，患者恢复期组和健康对照组Th17细胞比率和外周血IL-6、IL-17和IL-23水平无统计学差异；腹腔结核患者重症期腹水中的IL-6、IL-17和IL-23均高于其恢复期时腹水中的IL-6、IL-17和IL-23浓度，差异有统计学意义；重症腹腔结核患者Th17细胞和外周血IL-6、IL-17和IL-23呈正相关。结论：Th17细胞及相关细胞因子在腹腔结核重症患者的疾病发展过程中起着一定的调节作用，探索其分化与调控有助于认识它在疾病进展过程中的作用，也有利于生物学治疗靶点的发现。

Detection and Significance of Th17 Lymphocytes and Related Factors in Peripheral Blood and Ascites of Patients with Severe Abdominal Tuberculosis

Objective To detect Th17 lymphocytes and its related factors in peripheral blood and ascites of patients with severe abdominal tuberculosis and to discuss the changes of Th17 lymphocytes in its process. Methods The expression ratio of Th17 in peripheral blood using flow cytometry in patients with abdominal tu-berculosis in critical period was determined in convalescence and healthy controls. IL-6, IL-17, IL-23 levels by ELISA in serum of all three groups and in ascites of critical period and convalescence tuberculosis patients were detected. Differences between each set of these indicators and the correlation between the indicators were anal-ysed. Results Both the ratio of Th17 cells sharing CD4＋ T cells and the levels IL-6, IL-17 and IL-23 in pe-ripheral blood of critical period patients were significantly higher than those in the convalescent patients and healthy controls, the difference between convalescent patients and healthy controls was not statistically signifi-cient. The levels of IL-6, IL-17 and IL-23 in ascites in critical period were higher than those in convalescence patients with statistically significant difference. Th17 cell ratio in patients with severe abdominal tuberculosis was positively correlated with the levels of IL-6, IL-17 and IL-23 in peripheral blood. Conclusion Th17 cells and related factors plays a certain regulative function in the development of abdominal tuberculosis in patients with severe disease. Exploration of differentiation and regulation mechanism of the cells helps to un-derstand the role in disease progression and to discover the biological therapeutic targets.