东南大学学报（医学版）
東南大學學報（醫學版）
동남대학학보（의학판）
JOURNAL OF SOUTHEAST UNIVERSITY(MEDICAL SCIENCE EDITION)
2015年
4期
525-531
,共7页
范任华%向延根%杨励%刘艳科%陈平圣%尹柯%许忆新%封文军%傅满姣%吴佳玲%王雷%齐志强%喻容%张婷
範任華%嚮延根%楊勵%劉豔科%陳平聖%尹柯%許憶新%封文軍%傅滿姣%吳佳玲%王雷%齊誌彊%喻容%張婷
범임화%향연근%양려%류염과%진평골%윤가%허억신%봉문군%부만교%오가령%왕뢰%제지강%유용%장정
调节性T细胞CD4 +CD25 +CD127low%CD4 +T细胞%CD8 +T细胞%多耐药肺结核
調節性T細胞CD4 +CD25 +CD127low%CD4 +T細胞%CD8 +T細胞%多耐藥肺結覈
조절성T세포CD4 +CD25 +CD127low%CD4 +T세포%CD8 +T세포%다내약폐결핵
CD4+CD25+CD127low regulatory T cells%CD4+T cells%CD8+T cells%multi-drug resistant pulmonary tuberculosis
目的：探讨调节性T细胞CD4＋CD25＋CD127low、CD4＋及CD8＋T细胞在多耐药结核患者中的免疫调节作用。方法：采取30例健康体检者（ HD ）、30例非耐药初治肺结核（ S－TB ）患者及30例多耐药结核病（ MDR－TB）患者2 ml肝素抗凝外周静脉血，经CD3、CD4、CD8、CD25、CD127流式抗体标记后Beckman流式细胞仪计数各组CD4＋CD25＋CD127low、CD3＋、CD4＋、CD8＋百分比含量，计算CD4／CD8值。结果：MDR－TB组CD4＋CD25＋CD127low调节性T细胞百分比含量明显高于HD组与S－TB组（P＝0．000），MDR－TB组CD4＋T细胞百分比含量明显低于HD组与S－TB组（P＜0．05），MDR－TB组CD8＋T细胞百分比含量与HD组与S－TB组相比明显上升（P＜0．05），MDR－TB组CD4／CD8值明显低于HD组与S－TB组（P＜0．001）；线性回归分析发现：HD组中CD4＋CD25＋CD127low调节性T细胞百分比含量与CD3＋、CD4＋、CD8＋T细胞及CD4／CD8值均无相关性（P＞0．05），非耐药初治肺结核患者CD4＋CD25＋CD127low调节性T细胞百分比含量与CD3＋、CD4＋T细胞无相关性（P＞0．05）、与CD8＋T细胞存在正相关（r＝0．419，P＝0．011）、与CD4／CD8值存在负相关（r＝－0．519，P＝0．002），耐药结核病患者CD4＋CD25＋CD127low调节性T细胞百分比含量与CD3＋T细胞无相关性（P＞0．05）、与CD4＋存在负相关（r＝－0．476，P ＝0．004）、与CD8＋T细胞存在正相关（r ＝0．638，P＝0．000）、与CD4／CD8值存在负相关（r＝－0．776，P＝0．000）。结论：随着肺结核病程的发展，外周血中CD4＋CD25＋CD127low调节性T细胞逐渐上调，特异性细胞免疫水平下调，二者之间存在相关性，调节性T细胞可能通过抑制结核患者特异性细胞免疫应答来影响肺结核病的进程。
目的：探討調節性T細胞CD4＋CD25＋CD127low、CD4＋及CD8＋T細胞在多耐藥結覈患者中的免疫調節作用。方法：採取30例健康體檢者（ HD ）、30例非耐藥初治肺結覈（ S－TB ）患者及30例多耐藥結覈病（ MDR－TB）患者2 ml肝素抗凝外週靜脈血，經CD3、CD4、CD8、CD25、CD127流式抗體標記後Beckman流式細胞儀計數各組CD4＋CD25＋CD127low、CD3＋、CD4＋、CD8＋百分比含量，計算CD4／CD8值。結果：MDR－TB組CD4＋CD25＋CD127low調節性T細胞百分比含量明顯高于HD組與S－TB組（P＝0．000），MDR－TB組CD4＋T細胞百分比含量明顯低于HD組與S－TB組（P＜0．05），MDR－TB組CD8＋T細胞百分比含量與HD組與S－TB組相比明顯上升（P＜0．05），MDR－TB組CD4／CD8值明顯低于HD組與S－TB組（P＜0．001）；線性迴歸分析髮現：HD組中CD4＋CD25＋CD127low調節性T細胞百分比含量與CD3＋、CD4＋、CD8＋T細胞及CD4／CD8值均無相關性（P＞0．05），非耐藥初治肺結覈患者CD4＋CD25＋CD127low調節性T細胞百分比含量與CD3＋、CD4＋T細胞無相關性（P＞0．05）、與CD8＋T細胞存在正相關（r＝0．419，P＝0．011）、與CD4／CD8值存在負相關（r＝－0．519，P＝0．002），耐藥結覈病患者CD4＋CD25＋CD127low調節性T細胞百分比含量與CD3＋T細胞無相關性（P＞0．05）、與CD4＋存在負相關（r＝－0．476，P ＝0．004）、與CD8＋T細胞存在正相關（r ＝0．638，P＝0．000）、與CD4／CD8值存在負相關（r＝－0．776，P＝0．000）。結論：隨著肺結覈病程的髮展，外週血中CD4＋CD25＋CD127low調節性T細胞逐漸上調，特異性細胞免疫水平下調，二者之間存在相關性，調節性T細胞可能通過抑製結覈患者特異性細胞免疫應答來影響肺結覈病的進程。
목적：탐토조절성T세포CD4＋CD25＋CD127low、CD4＋급CD8＋T세포재다내약결핵환자중적면역조절작용。방법：채취30례건강체검자（ HD ）、30례비내약초치폐결핵（ S－TB ）환자급30례다내약결핵병（ MDR－TB）환자2 ml간소항응외주정맥혈，경CD3、CD4、CD8、CD25、CD127류식항체표기후Beckman류식세포의계수각조CD4＋CD25＋CD127low、CD3＋、CD4＋、CD8＋백분비함량，계산CD4／CD8치。결과：MDR－TB조CD4＋CD25＋CD127low조절성T세포백분비함량명현고우HD조여S－TB조（P＝0．000），MDR－TB조CD4＋T세포백분비함량명현저우HD조여S－TB조（P＜0．05），MDR－TB조CD8＋T세포백분비함량여HD조여S－TB조상비명현상승（P＜0．05），MDR－TB조CD4／CD8치명현저우HD조여S－TB조（P＜0．001）；선성회귀분석발현：HD조중CD4＋CD25＋CD127low조절성T세포백분비함량여CD3＋、CD4＋、CD8＋T세포급CD4／CD8치균무상관성（P＞0．05），비내약초치폐결핵환자CD4＋CD25＋CD127low조절성T세포백분비함량여CD3＋、CD4＋T세포무상관성（P＞0．05）、여CD8＋T세포존재정상관（r＝0．419，P＝0．011）、여CD4／CD8치존재부상관（r＝－0．519，P＝0．002），내약결핵병환자CD4＋CD25＋CD127low조절성T세포백분비함량여CD3＋T세포무상관성（P＞0．05）、여CD4＋존재부상관（r＝－0．476，P ＝0．004）、여CD8＋T세포존재정상관（r ＝0．638，P＝0．000）、여CD4／CD8치존재부상관（r＝－0．776，P＝0．000）。결론：수착폐결핵병정적발전，외주혈중CD4＋CD25＋CD127low조절성T세포축점상조，특이성세포면역수평하조，이자지간존재상관성，조절성T세포가능통과억제결핵환자특이성세포면역응답래영향폐결핵병적진정。
Objective:To study the role of CD4 +CD25 +CD127low regulatory T cells, CD4 +and CD8 +T cells in patients with multidrug-resistant tuberculosis.Methods:30 cases of healthy donors(HD),30 cases of patients with susceptible primary tuberculosis ( S-TB ) , 30 cases of patients with multidrug-resistant pulmonary tuberculosis ( MDR-TB) were involved.2 ml of peripheral venous blood was injected into heparin anticoagulation tube, labeled with the monoclonal antibody of CD3, CD4, CD8, CD25 and CD127.The percentage of CD4 +CD25 +CD127low regulatory T cells, CD3 +, CD4 +and CD8 +T cells was counted by using Beckman flow cytometry( FCM) , and the calculation of CD4/CD8 was conducted.Results: The percentage of CD4 +CD25 +CD127low T cells in MDR-TB patients was significantly higher than that in the HD group and in the S-TB group(P=0.000), the percentage of CD4 +T cells in MDR-TB group was significantly lower than that in the HD group and in the S-TB group( P<0.05) , and the percentage of CD8+T cells in MDR-TB increased significantly compared with that in the HD group ( P<0.05), the ratio of CD4/CD8 in MDR-TB group was significantly lower than that in the HD group and in the S-TB group(P<0.001).There was no correlation between the percentage of CD4 +CD25 +CD127low regulatory T cells and the percentage of CD3 +, CD4 +, CD8 +and CD4/CD8 in HD by using the method of linear regression analysis (P>0.05).In drug-susceptible TB patients, there was no correlation between the percentage of CD4 +CD25 +CD127low regulatory T cells and the percentage of CD3 +and CD4 +(P>0.05), a positive correlation between the percentage of CD4 +CD25 +CD127low regulatory T cells and the percentage of CD8 +(r=0.419,P=0.011), and a negative correlation between the percentage of CD4 +CD25 +CD127low regulatory T cells and CD4/CD8 ratio(r=-0.519,P=0.002).In MDR-TB patients, there was no correlation between the percentage of CD4 +CD25 +CD127low regulatory T cells and the percentage of CD3 +(P>0.05), a positive correlation between the percentage of CD4 +CD25 +CD127low regulatory T cells and the percentage of CD8 +(r=0.638,P=0.000), and a negative correlation between the percentage of CD4 +CD25 +CD127low regulatory T cells and the percentage of CD4 +(r=-0.476,P=0.004) and CD4/CD8 ratio(r =-0.776,P =0.000).Conclusion: With the development of pulmonary tuberculosis, CD4 +CD25 +CD127low regulatory T cells gradually increase in the peripheral blood of pulmonary tuberculosis patients, and specific cellular immunity levels decline, there is a correlation in them, CD4 +CD25 +CD127low regulator T cells may inhibit specific cellular immune response in MDR-TB patients.
