CAJ | 학술논문

目的了解各类胸腹水中淋巴细胞分布水平及其对胸腹水性质鉴别诊断的意义.方法采用流式细胞术测定结核性(30例)和癌性患者(31例)外周血及胸腹水中T淋巴细胞亚群分布,ELISA法检测辅助T淋巴细胞(Th)1和Th2类细胞因子γ-干扰素(IFN-γ)、IL-12和IL-4的含量.结果结核性和癌性胸腹水中CD3+CD4+T淋巴细胞含量[(73±6)%与(67±20)%]均高于外周血[(51±19)%与(48±14)%](均P＜0.05).尽管结核性胸腹水中CD3+T淋巴细胞数量高于癌性胸腹水(P＜0.05),但两者CD3+CD4+和CD3+CD8+T淋巴细胞亚群分布差异无统计学意义(P＞0.05).结核性胸腹水中Th1与Th2类细胞因子比值(IFN-γ/IL-4与IL-12/IL-4)为54±24与82±19,明显高于癌性胸腹水的8±6与19±10(t值分别为10.34和16.28,均P＜0.01).结论结核性和癌性胸腹水中均存在CD3+CD+T淋巴细胞聚集,仅靠CD3+CD4+和(或)CD3+CD8+淋巴细胞亚群分析不足以鉴别炎性与恶性胸腹水,而Th1、Th2类细胞因子的测定有助于两者的鉴别诊断.
목적 료해각류흉복수중림파세포분포수평급기대흉복수성질감별진단적의의.방법 채용류식세포술측정결핵성(30례)화암성환자(31례)외주혈급흉복수중T림파세포아군분포,ELISA법검측보조T림파세포(Th)1화Th2류세포인자γ-간우소(IFN-γ)、IL-12화IL-4적함량.결과 결핵성화암성흉복수중CD3+CD4+T림파세포함량[(73±6)%여(67±20)%]균고우외주혈[(51±19)%여(48±14)%](균P＜0.05).진관결핵성흉복수중CD3+T림파세포수량고우암성흉복수(P＜0.05),단량자CD3+CD4+화CD3+CD8+T림파세포아군분포차이무통계학의의(P＞0.05).결핵성흉복수중Th1여Th2류세포인자비치(IFN-γ/IL-4여IL-12/IL-4)위54±24여82±19,명현고우암성흉복수적8±6여19±10(t치분별위10.34화16.28,균P＜0.01).결론 결핵성화암성흉복수중균존재CD3+CD+T림파세포취집,부고CD3+CD4+화(혹)CD3+CD8+림파세포아군분석불족이감별염성여악성흉복수,이Th1、Th2류세포인자적측정유조우량자적감별진단.
Objective To determine counts of T lymphocyte sub-populations in malignant and tuberculous pleural effusion or ascites and evaluate its significance in difierential diagnosis.Methods T lymphocyte sub-populations in pleural effusion or ascites and peripheral blood were determined in 30 patients with tuberculosis and 31 patients with cancer by flow cytometry.Concentrations of cytokines Th1 and Th2,γ-interferon(IFN-γ),interleukin-12(IL-12)and IL-4 in pleural effusion or ascites were measured by enzyme-linked immunosorbent assay(ELISA).Results Compared to that in peripheral blood,percentage of CD3+ and CD4+ T-celI counts were all higher in both malignant and tuberculous pleural effusion or ascites [(73±6)%and(67±20)%vs.(51±19)%and(48±14)%,P＜0.05].Although CD3+T-cells count was higher in tuberculous pleural effusions or ascites,no difference in ratio of CD3+ and CD4+/CD3+ and CD8+ T-cell counts was found between malignant and tuberculous pleural effusions or ascites.However,ratios of IFN-γ and IL-12 to IL-4 were higher in tuberculous pleural effusion or ascites(54±24 and 82±19vs.8±6 and 19±10,t=10.34 and 16.28,respectively,P＜0.01).Conclusions CD3+ and CD4+ Tcells can be aggregated in both malignant and tuberculous pleural effusions or ascites,80 nature (tuberculosis or malignancy)of pleural effusion or ascites can not be differentiated by CD4+ and/or CD8+ T-cell counts only,and determination of cytokines Th1 and Th2 can help their differentiation.