耐多药结核病患者细胞免疫功能的初步研究

发布时间：2018-04-22 00:04

本文选题：耐多药结核 + 细胞免疫功能　；参考：《实用预防医学》2016年10期

【摘要】：目的动态观察耐多药结核病患者机体细胞免疫状态,为临床诊治用药提供支持,为以后耐多药结核病的免疫治疗打下初步基础。方法用绝对浓度法进行药敏试验,筛选出耐多药结核(Multi-drug resistant tuberculosis,MDRTB)患者50例,药物敏感性结核(drug-susceptible tuberculosis,S-TB)患者50例,另于体检者中选取健康对照(healthy control,HC)20例,流式细胞分析淋巴细胞亚群(CD4~+、CD3~+、CD8~+分子等),酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测血清细胞因子(IFN-γ、IL-2、IL-4和IL-10等),比较耐多药结核病患者血清学与全敏结核病患者血清、正常人血清之间的差异。结果各组间CD3~+分子百分比差异无统计学意义,健康组与各结核组CD4+、CD8~+、CD4~+/CD8~+百分比差异有统计学意义,耐多药结核组与结核敏感组CD4~+、CD8~+、CD4~+/CD8~+百分比差异有统计学意义。健康组与各结核组IFN-γ、IL-2、IL-4和IL-10的浓度差异均有统计学意义,耐多药结核组与结核敏感组IL-2、IL-4和IL-10的浓度差异有统计学意义。耐多药结核组CD4~+、CD4~+/CD8~+比值、IL-2显著低于结核敏感组,CD8~+、IL-4和IL-10显著高于结核敏感组(P0.05)。结论结核病患者细胞免疫功能均下降,表现为CD4~+淋巴细胞百分比降低,CD8~+淋巴细胞百分比升高,CD4~+/CD8~+比值降低甚至倒置,增强抗结核免疫反应的细胞因子IFN-γ、IL-2浓度降低而抑制此反应的细胞因子IL-4和IL-10浓度升高。耐多药结核病患者较敏感结核病患者的细胞免疫功能进一步下降,表现为上述变化更加显著,使病情表现更加复杂及增加了治疗难度。
[Abstract]:Objective to observe the cellular immune status of MDR-TB patients dynamically, to provide support for clinical diagnosis and treatment of MDR-TB, and to lay a preliminary foundation for the immunotherapy of MDR-TB in the future. Methods 50 patients with multi-drug resistant tuberculosism MDRTB, 50 patients with drug-sensitive tuberculosis tuberculiasis S-TBand 20 healthy control patients were selected by absolute concentration test. Lymphocyte subsets CD4 ~ + CD3 ~ + CD8 ~ + were analyzed by flow cytometry and enzyme linked immunosorbent assaysis-ELISA-linked enzyme linked immunosorbent assay (Elisa) was used to detect serum cytokines, such as IFN- 纬, IL-2IL-4 and IL-10, and to compare the difference between the serum of MDR-TB patients and the sera of the patients with MDR-TB and the healthy people. Results there was no significant difference in the percentage of CD3- molecule between each group, but there was significant difference between the healthy group and the tuberculosis group in the percentage of CD4 CD8 ~ / / CD8 ~%, while there was a significant difference in the percentage of CD4 ~ + CD8 ~-/ -CD8 ~ ~ between the MDR-TB group and the TB sensitive group. The concentrations of IL-4 and IL-10 were significantly different between the healthy group and the tuberculosis group, and the concentrations of IL-4 and IL-10 were significantly different between the multi-drug resistant tuberculosis group and the tuberculosis sensitive group. In MDR-TB group, the ratio of CD4 ~ / CD4 ~ / CD8 ~ ~ + was significantly lower than that in susceptible TB group (P 0.05), and the levels of CD8 ~ + IL-4 and IL-10 in MDR-TB group were significantly higher than those in TB sensitive group (P < 0.05). Conclusion the cellular immune function of tuberculosis patients is decreased, the percentage of CD4 ~ lymphocytes is decreased and the percentage of CD8 ~ lymphocytes is increased. The ratio of CD4 ~ / / CD8 ~ ~ is decreased or even inverted. The concentration of IFN- 纬 -IL-2, a cytokine that enhanced the anti-tuberculosis immune response, decreased, while the concentration of cytokines IL-4 and IL-10, which inhibited the response, increased. The cellular immune function of the more sensitive TB patients with MDR-TB decreased further, which showed that the above changes were more significant, which made the disease more complex and more difficult to treat.
【作者单位】：长沙市中心医院检验科;
【基金】：十二五重大专项课题项目(2013ZX10005004-004)
【分类号】：R52

【相似文献】