CAJ | 학술논문

目的：分析空洞型肺结核患者手术治疗前后外周血调节性T细胞（ CD4＋CD25＋FoxP3＋）的改变。方法选择13例空洞型肺结核患者，在手术治疗前、手术后1个月、手术后6个月，分别抽取外周血，采用多色荧光抗体标记，多参数流式细胞似检测CD4＋CD25highT细胞及CD4＋CD25＋FoxP3＋T细胞水平，同时抽取10例健康者外周血与之对照。结果（1）空洞型肺结核患者手术前外周血CD4＋CD25＋T细胞水平明显低于健康者（P＜0．01）；CD4＋CD25＋T细胞，CD4＋CD25highT细胞及CD4＋CD25＋FoxP3＋T细胞水平明显高于健康者（P＜0．01）；术后6个月，CD4＋CD25highT细胞及CD4＋CD25＋FoxP3＋T细胞水平与健康者差异均无统计学意义（P＞0．05）。（2）与手术前比较，空洞型结核病患者行手术治疗后1个月和6个月，CD4＋，CD4＋CD25highT细胞水平明显升高，差异有统计学意义（P＜0．01）。手术6个月后CD4＋CD25high T细胞及CD4＋CD25＋FoxP3＋T细胞水平明显下降，差异均有统计学意义（P＜0．01）；（3）CD4＋CD25highT细胞与CD4＋CD25＋FoxP3＋T细胞水平之间存在高度正相关性（r＝0．878，P＜0．01）。结论空洞型肺结核患者外周血CD4＋CD25＋FoxP3＋T细胞水平明显升高，有效手术治疗后明显下降，CD4＋CD25＋FoxP3＋T细胞增殖可能与结核分枝杆菌的诱导刺激有关，且其表达水平可能与结核分枝杆菌的菌量负荷有关。
목적：분석공동형폐결핵환자수술치료전후외주혈조절성T세포（ CD4＋CD25＋FoxP3＋）적개변。방법선택13례공동형폐결핵환자，재수술치료전、수술후1개월、수술후6개월，분별추취외주혈，채용다색형광항체표기，다삼수류식세포사검측CD4＋CD25highT세포급CD4＋CD25＋FoxP3＋T세포수평，동시추취10례건강자외주혈여지대조。결과（1）공동형폐결핵환자수술전외주혈CD4＋CD25＋T세포수평명현저우건강자（P＜0．01）；CD4＋CD25＋T세포，CD4＋CD25highT세포급CD4＋CD25＋FoxP3＋T세포수평명현고우건강자（P＜0．01）；술후6개월，CD4＋CD25highT세포급CD4＋CD25＋FoxP3＋T세포수평여건강자차이균무통계학의의（P＞0．05）。（2）여수술전비교，공동형결핵병환자행수술치료후1개월화6개월，CD4＋，CD4＋CD25highT세포수평명현승고，차이유통계학의의（P＜0．01）。수술6개월후CD4＋CD25high T세포급CD4＋CD25＋FoxP3＋T세포수평명현하강，차이균유통계학의의（P＜0．01）；（3）CD4＋CD25highT세포여CD4＋CD25＋FoxP3＋T세포수평지간존재고도정상관성（r＝0．878，P＜0．01）。결론공동형폐결핵환자외주혈CD4＋CD25＋FoxP3＋T세포수평명현승고，유효수술치료후명현하강，CD4＋CD25＋FoxP3＋T세포증식가능여결핵분지간균적유도자격유관，차기표체수평가능여결핵분지간균적균량부하유관。
Objective To analyze the regulatory T cell ( CD4 +CD25 +FoxP3 +T) levels in peripheral blood of patients with cavitary tuberculosis before and after surgery .Methods We compared the proportion of CD4 +CD25high T cells and CD4 +CD25 +FoxP3 +T cells in 13 patients with cavity tuberculosis pre-and post-operatively and in 10 healthy control subjects with flow cytometry .Results (1) The proportion of CD4 +CD25high T cells and CD4 +CD25 +FoxP3 +T cells were significantly higher in patients with cavity tuberculosis and at 1-month postoperatively than that in healthy controls(P<0.01).The proportion of CD4 +CD25high T cells and CD4 +CD25 +FoxP3 +T cells had no statistical significance between the patients with cavity tuberculosis at 6-months postoperatively and healthy controls (P>0.05).(2)The proportion of CD4 +CD25high T cells and CD4 +CD25 +FoxP3 +T cells decreased significantly af-ter 6 months surgery than preoperatively in patients with cavity tuberculosis (P<0.01).(3)Pre-and post-operative proportions of CD4 +CD25high T cells and CD4 +CD25 +FoxP3 +T cells showed a positive correlation ( r=0.878,P<0.01 ) .Conclusion The proportion of the circulating T regulatory cells increases in patients with cavity tuberculosis , and decreases after surgery .Infection with M.tuberculosis may induce regulatory T cell-surface molecular changes.