初治肺结核患者T淋巴细胞亚群和Th细胞的变化及与预后的关系.pdf

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1、·临床研究·中国当代医药2014年1O月第21卷第28期初治肺结核患者T淋巴细胞亚群和Th细胞的变化及与预后的关系许建民浙江省苍南县人民医院内科。浙江苍南325800【摘要】目的探讨初治肺结核患者T淋巴细胞亚群和Th细胞的变化及与预后的关系。方法选取2011年1月2013年6月在本院结核科门诊治疗的肺结核患者60例为肺结核组，按初治疗效进一步将肺结核组分为好转组与未好转组，选取健康未患肺结核30例为对照组。测定外周血T细胞亚群、Th细胞及IFN一、IL一4。结果治疗前，未好转组CD4+,CD+／CDs~,Thl／Th

2、2、Th1表达较对照组与好转组显著降低，rI’Il2表达较对照组与好转组显著升高(P<0．05)；治疗前，好转组CD、Thl／Th2、Thl表达较对照组低，Th2表达较对照组高(P<0．05)；治疗后，好转组CD4+xCD；／CD、Thl／Th2、Th1显著高于未好转组及治疗前，Th2显著低于未好转组及治疗前，差异有统计学意义(P<0．05)；与治疗前比较，未好转组治疗后CD4+,CD8+CD4+／CDs~,Thl／Th2、Thl、Th2差异无统计学意义(P>0．05)。结论初治肺结核患者CD、CD+／CD。、Thl

3、／Th2、Thl较正常人降低，，I’h2较正常人升高；肺结核治疗初期，CD、CD+／CD8、Thl／Th2、Thl偏高，Th2偏低的患者预后较好；治疗有效后CD4、CD4+／CD8、Thl／Th2、Thl升高，Th2下降。【关键词1初治；肺结核；T细胞亚群；Th细胞[中图分类号】R521【文献标识码】A【文章编号】1674—4721(2014)10(a)一OO40—04ThechangeofTlymphocytesubsetsandThcellsanditsrelationshipwithprognosisinthe

4、earlycuretuberculosispatientsXUJian—rainDepartmentofMedicine，PeoplesHospitalofCangnanCountyinZhejiangProvince，Cangnan325800，China[Abstract]ObjectiveToinvestigatethechangeofTlymphocytesubsetsandThcellsanditsrelationshipwithprogno—sisintheearlycuretuberculosispat

5、ients．Methods60patientswithtuberculosisintuberculosisoutpatientclinicfromJanuary2011toJune2013wereselectedastuberculosisgroup，theyweredividedintoimprovedgroupandnon-im—provedgroupaccordingtoearlycuretuberculosiscurativeeffect．30casesofhealthypeoplewithouttuberc

6、ulosiswereselectedascontrolgroup．PeripheralbloodTcellsubgroup，ThandIFN-7，IL一4wasdetectedrespectively．ResultsBe—foretreatment，CD4+，CD4+／CDs+，Th1／Th2，Thlofnon-improvedgroupwassignificantlylowerthanthatofcontrolgroupandimprovedgrouprespectively，Th2ofnon—improvedgr

7、oupwassignificantlyhigherthanthatofcontrolgroupandim-provedgrouprespectively(P<0．05)．Beforetreatment，CD4+，Thl／Th2，Thlofimprovedgroupwaslowerthanthatofcontrolgrouprespectively，Th2ofimprovedgroupwashigherthanthatofcontrolgroup(P≮O．05)．Aftertreatment，CD；，CD4+]CD8+

8、，Thl／Th2，Thlofimprovedgroupwassignificantlyhigherthanthatofnon-improvedgroupandbeforetreatmentrespec—tively，Th2ofimprovedgroupwassignificantlylowerthanthatofnon-improvedgrou