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目的:探讨肺结核患者强化治疗期外周血CD4+T细胞变化的临床意义。方法:应用流式细胞术对62例肺结核患者外周血的CD4+T细胞计数,根据患者治疗前影像学肺部病灶累及程度及治疗前后影像学变化进行分组比较,并与30例健康者作比较。结果:治疗前肺结核组CD4+T细胞计数(439.21±210.56)/mm3明显低于健康对照组(748.47±261.85)/mm3(P<0.01)。治疗前多叶受累组的CD4+T细胞计数(399.83±194.17)/mm3低于局限组对应的(521.90±224.40)/mm3(P<0.05);治疗后病灶吸收明显组的CD4+T细胞计数从(480.75±228.49)/mm3上升至(616.75±280.57)/mm3,达健康组水平(P>0.05),而病灶吸收不明显的CD4+T细胞计数仅从(412.97±197.00)/mm3上升至(447.55±204.60)/mm3,仍低于健康水平(P<0.01)。结论:肺结核患者存在外周血CD4+T细胞减少,经抗结核治疗后,外周血减少的CD4+T细胞部分可恢复,外周血CD4+T细胞与肺结核病情严重性相关,病情越严重CD4+T细胞数越低。
Objective: To investigate the clinical significance of the changes of CD4 + T cells in peripheral blood of patients with pulmonary tuberculosis during intensive therapy. Methods: Flow cytometry was used to count the number of CD4 + T cells in peripheral blood of 62 patients with pulmonary tuberculosis. According to the degree of lung involvement before and after treatment and the changes of the imaging before and after treatment, CD4 + T cell counts were compared with those of 30 healthy controls . Results: Before treatment, CD4 + T cell count (439.21 ± 210.56) / mm3 in tuberculosis group was significantly lower than that in healthy control group (748.47 ± 261.85) / mm3 (P <0.01). The CD4 + T cell count (399.83 ± 194.17) / mm3 in the multileaf affected group before treatment was lower than that in the localized group (521.90 ± 224.40) / mm3 (P <0.05), and the CD4 + T cell count (480.75 ± 228.49) / mm3 to (616.75 ± 280.57) / mm3, reaching the level of healthy group (P> 0.05), while the count of CD4 + T cells with unclear lesions increased only from (412.97 ± 197.00) / mm3 to (447.55 ± 204.60) / mm3, still lower than the healthy level (P <0.01). Conclusion: There is a decrease of CD4 + T cells in peripheral blood of patients with pulmonary tuberculosis. After anti-TB treatment, CD4 + T cells reduced in peripheral blood can be recovered. CD4 + T cells in peripheral blood are correlated with the severity of pulmonary tuberculosis. The lower the cell number.