CAJ | 학술논문

目的比较结核性胸膜炎患者外周血和胸腔积液中结核特异性T淋巴细胞的免疫反应.方法收集2012年10月至2013年4月在无锡市第五人民医院住院的结核性胸膜炎初治患者12例.同时采集其外周血和胸腔积液,细胞内细胞因子染色和流式细胞术检测外周血和胸腔积液中CD4+ IFN-γ+T淋巴细胞和CD8+ IFN-γ+T淋巴细胞的比例.数据分析采用非参数MannWhitney检验和配对秩和检验.结果入选患者外周血分泌IFN-γ的CD4+T淋巴细胞占CD4+T淋巴细胞总数的中位数为0.91％,而胸腔积液中则达3.63％,显著高于外周血,差异有统计学意义(U=17.00,P=0.0017).进一步的配对秩和检验分析亦显示,胸腔积液中分泌IFN-γ的CD4+T淋巴细胞比例与外周血相比有显著的升高趋势(P=0.0015);而CD8+T淋巴细胞则无此变化趋势(P=0.9219).结论在结核性胸膜炎的发病过程中,结核特异性CD4+T淋巴细胞从外周血迁徙至胸腔,在病变局部发挥抗结核免疫作用.
목적 비교결핵성흉막염환자외주혈화흉강적액중결핵특이성T림파세포적면역반응.방법 수집2012년10월지2013년4월재무석시제오인민의원주원적결핵성흉막염초치환자12례.동시채집기외주혈화흉강적액,세포내세포인자염색화류식세포술검측외주혈화흉강적액중CD4+ IFN-γ+T림파세포화CD8+ IFN-γ+T림파세포적비례.수거분석채용비삼수MannWhitney검험화배대질화검험.결과 입선환자외주혈분비IFN-γ적CD4+T림파세포점CD4+T림파세포총수적중위수위0.91％,이흉강적액중칙체3.63％,현저고우외주혈,차이유통계학의의(U=17.00,P=0.0017).진일보적배대질화검험분석역현시,흉강적액중분비IFN-γ적CD4+T림파세포비례여외주혈상비유현저적승고추세(P=0.0015);이CD8+T림파세포칙무차변화추세(P=0.9219).결론 재결핵성흉막염적발병과정중,결핵특이성CD4+T림파세포종외주혈천사지흉강,재병변국부발휘항결핵면역작용.
Objective To compare the immune responses of Mycobacterium tuberculosis (M.tb)-specific T lymphocytes between the peripheral blood and pleural effusion in patients with tuberculous pleurisy.Methods Twelve initially treated cases of tuberculous pleurisy who were hospitalized in Wuxi No.5 People's Hospital from Oct 2012 to Apr 2013 were enrolled in this study.Both the peripheral blood and pleural effusion were collected from the enrolled patients.The percentages of CD4+ IFN-γ+ T lymphocytes and CD8+ IFN-γ+ T lymphocytes in the peripheral blood and pleural effusion were determined by intracellular cytokine staining and flow cytometry.The data were compared by non-parametric Mann-Whitney test and Wilcoxon matched pairs test.Results The percentage of CD4+ IFN-γ+ T lymphocytes in the total CD4+ T lymphocytes in the peripheral blood of the patients was 0.91％,while that was 3.63％ in pleural effusion,which was significantly higher than that in the peripheral blood (U=17.00,P=0.0017).Further Wilcoxon matched pairs test showed that the proportion of CD4+ T lymphocytes secreting IFN γ in pleural effusion was also significantly higher than that in the peripheral blood (P=0.0015).However,there was no significant difference of CD8+ T lymphocytes secreting IFN-γ between blood and pleural effusion (P=0.9219).Conclusions M.tb-specific CD4+ T lymphocytes immigrate from the peripheral blood to the pleural cavity during the development of tuberculous pleurisy,and exert an anti-tuberculosis immunological effect in local lesion.