CAJ | 학술논문

目的：探讨结核患者多功能CD8 T细胞的表达水平及其临床意义。方法：采用流式细胞术检测结核患者（TB）、潜伏感染者（LTBI）、健康对照（HC）外周血单个核细胞（PBMCs）或胸腔积液单个核细胞（PFMCs）结核特异性及非特异性多功能性CD8T细胞表达水平。结果：非特异性抗原（PMA＋I）刺激下，TB组PBMCs中多功能性CD8T细胞（IL-2＋ IFN-γ＋ TNF-α＋ CD8 T细胞）频率[（5．72±4．32）％]显著低于HC [（22．3±15．7）％（q＝7．455，P＜0．001）]和LTBI[（14．2±7．72）％，（q＝3．110，P＜0．05）]；结核菌特异性抗原（MTB裂解液）刺激下，TB组PBMCs中多功能性CD8T细胞频率[（0．33±0．83）％]高于HC[（0．017±0．03）％（q＝3．97，P＜0．05）]和LTBI[（0．019±0．035）％，（q＝3．39，P＜0．05）]；结核性胸膜炎患者PFMCs多功能CD8 T细胞频率[（0．623±1．033）％]显著高于相应的PBMCs[（0．034±0．066）％，（P＜0．001）]；结核患者PBMCs多功能性CD8 T细胞表达水平和其HRCT评分呈负相关（r＝-0．2658，P＝0．0158）。结论：多功能CD8 T细胞表达水平检测有助于鉴别诊断结核患者和潜伏感染者，其与结核患者的病理损伤程度密切相关。
목적：탐토결핵환자다공능CD8 T세포적표체수평급기림상의의。방법：채용류식세포술검측결핵환자（TB）、잠복감염자（LTBI）、건강대조（HC）외주혈단개핵세포（PBMCs）혹흉강적액단개핵세포（PFMCs）결핵특이성급비특이성다공능성CD8T세포표체수평。결과：비특이성항원（PMA＋I）자격하，TB조PBMCs중다공능성CD8T세포（IL-2＋ IFN-γ＋ TNF-α＋ CD8 T세포）빈솔[（5．72±4．32）％]현저저우HC [（22．3±15．7）％（q＝7．455，P＜0．001）]화LTBI[（14．2±7．72）％，（q＝3．110，P＜0．05）]；결핵균특이성항원（MTB렬해액）자격하，TB조PBMCs중다공능성CD8T세포빈솔[（0．33±0．83）％]고우HC[（0．017±0．03）％（q＝3．97，P＜0．05）]화LTBI[（0．019±0．035）％，（q＝3．39，P＜0．05）]；결핵성흉막염환자PFMCs다공능CD8 T세포빈솔[（0．623±1．033）％]현저고우상응적PBMCs[（0．034±0．066）％，（P＜0．001）]；결핵환자PBMCs다공능성CD8 T세포표체수평화기HRCT평분정부상관（r＝-0．2658，P＝0．0158）。결론：다공능CD8 T세포표체수평검측유조우감별진단결핵환자화잠복감염자，기여결핵환자적병리손상정도밀절상관。
Objective To explore the expression level and clinical significance of multifunctional CD8 T cells in patients with tuberculosis (TB). Methods The expression levels of MTB antigen specific and non-specific multifunctional CD8 T cells among peripheral blood mononuclear cells (PBMCs) and pleural fluid mononuclear cells (PFMCs) in TB patients, latent tuberculosis infection patients (LTBI) and healthy controls (HC) were measured by flow cytometry. Results The expression level of multifunctional CD8 T cells (IL-2+IFN-γ+TNF-α+CD8 T cells) among PBMCs stimulated by non-specific MTB antigen in TB patients was (5.72 ± 4.32)%, which was significantly lower than those in HC and LTBI [(22.3 ± 15.7)%, q=7.455, P<0.001;(14.2 ± 7.72)%, q=3.110, P<0.05]. Under the stimulation by specific MTB antigen, the expression level of multifunctional CD8 T cells among PBMCs in TB patients was (0.33 ± 0.83)%, which was significantly higher than those in HC and LTBI [(0.017 ± 0.03)%, q=3.97, P<0.05;(0.019 ± 0.035)%, q=3.39, P<0.05]. In patients with tuberculous pleurisy, the expression level of multifunctional CD8 T cells among PFMCs was (0.623 ± 1.033)%, which was significantly higher than that among PBMCs [(0.034 ± 0.066)%, P<0.001]. The expression level of multifunctional CD8 T cells in TB patients was negatively correlated with HRCT score (r=-0.265 8, P=0.015 8). Conclusion The expression level of multifunctional CD8 T cells was contributed to discriminate TB patients from latent tuberculosis infection patients , and was closely related to the degree of damage in lung.