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目的分析不同期别矽肺患者周围血淋巴细胞亚群和肿瘤坏死因子(TNF)的变化,探讨不同期别矽肺患者免疫水平的差异。方法应用直接免疫荧光-流式细胞技术检测32例(Ⅰ期16例、Ⅱ期10例、Ⅲ期6例)矽肺患者周围血淋巴细胞亚群,同时应用酶联免疫吸附法(ELISA)的方法检测血清中TNF-α的水平,与24例正常健康人作比较。结果周围血CD3+CD4+T淋巴细胞比例和CD4/CD8矽肺患者组低于正常人组(P<0.05),随着矽肺期别的升高,CD3+CD4+T淋巴细胞比例明显下降(P<0.05);CD3-CD19+细胞比例矽肺患者组均高于正常对照组(P<0.05),随着矽肺期别升高,CD3-CD19+细胞比例逐渐增加(P<0.05);CD3-CD56+细胞和CD3+CD8+T细胞比例在不同期别矽肺患者组和正常人组间差异均无显著性(P>0.05)。各期矽肺患者周围血TNF-α的水平低于正常对照组(P<0.05),矽肺Ⅱ期和Ⅲ期组低于矽肺Ⅰ期组(P<0.05)。结论矽肺患者周围血细胞免疫功能低下,B细胞介导体液免疫的上调。
Objective To analyze the changes of peripheral blood lymphocyte subsets and tumor necrosis factor (TNF) in patients with different stages of silicosis and to explore the difference of immune levels in patients with different stages of silicosis. Methods Direct immunofluorescence-flow cytometry was used to detect the peripheral blood lymphocyte subsets in 32 patients (16 in stage Ⅰ, 10 in stage Ⅱ and 6 in stage Ⅲ), and the levels of peripheral blood lymphocytes were detected by enzyme-linked immunosorbent assay (ELISA) Serum levels of TNF-α were measured and compared with 24 normal healthy subjects. Results The proportion of CD3 + CD4 + T lymphocytes in peripheral blood and CD4 / CD8 silicosis patients were significantly lower than those in normal controls (P <0.05). The proportion of CD3 + CD4 + T lymphocytes decreased significantly with the increase of silicosis <0.05). The proportion of CD3-CD19 + cells in patients with silicosis was significantly higher than that in controls (P <0.05). The proportion of CD3-CD19 + cells increased with the increase of silicosis (P <0.05) There was no significant difference in the proportion of CD3 + CD8 + T cells in different stages of silicosis patients and normal controls (P> 0.05). The levels of TNF-α in the peripheral blood of patients with silicosis were lower than those in the normal control group (P <0.05), and those in the silicosis stage Ⅱ and Ⅲ were lower than those in the silicosis stage Ⅰ (P <0.05). Conclusion The peripheral blood cells of patients with silicosis are poorly immunized, and B cells mediate the up-regulation of humoral immunity.