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目的探讨CD3+T细胞、CD3+CD16+CD56+N KT细胞及CD3-CD16+CD56+N K细胞在肺结核患者外周血的表达状态及其临床意义。方法采用流式细胞仪分析123例肺结核患者(73例初治肺结核和50例复治肺结核)及83例健康者(43例结核菌素皮试阳性和40例结核菌素皮试阴性)外周血中T细胞、NKT和NK细胞的表达率。结果初、复治肺结核患者的NKT细胞表达率明显高于健康者(P<0.01),但初治肺结核患者的NK细胞、T细胞的表达率与健康者相比差异无统计学意义(P>0.05)。T细胞表达率在不同程度的初治肺结核患者中差异有统计学意义(P<0.01),疾病越重,表达越高。NKT、NK细胞差异无统计学意义(P>0.05)。复治肺结核患者的T细胞表达率显著高于初治肺结核患者(P<0.01),但NK细胞、NKT细胞的表达率在2组间差异无统计学意义(P>0.05)。结论T细胞、NKT细胞是结核病细胞免疫的重要组成部分。对NKT细胞只在活动性肺结核患者才会呈现高表达,测定外周血NKT细胞可能成为辅助诊断活动性肺结核的手段之一。
Objective To investigate the expression of CD3 + T cells, CD3 + CD16 + CD56 + N KT cells and CD3-CD16 + CD56 + N K cells in peripheral blood of patients with pulmonary tuberculosis and its clinical significance. Methods 123 cases of pulmonary tuberculosis (73 cases of newly diagnosed pulmonary tuberculosis and 50 cases of re-treatment of pulmonary tuberculosis) and 83 cases of healthy (43 cases of tuberculin skin test positive and 40 cases of tuberculin skin test negative) peripheral blood were analyzed by flow cytometry T cell, NKT and NK cell expression rate. Results At first, the expression of NKT cells in retreatment tuberculosis patients was significantly higher than that in healthy controls (P <0.01). However, the expression of NK cells and T cells in newly diagnosed tuberculosis patients was not significantly different from healthy controls (P> 0.05). T cell expression in different degree of newly diagnosed tuberculosis patients was significantly different (P <0.01), the disease more severe, the higher the expression. There was no significant difference between NKT and NK cells (P> 0.05). The expression of T cells in retreatment tuberculosis patients was significantly higher than that in newly diagnosed tuberculosis patients (P <0.01). However, there was no significant difference in the expression rates of NK cells and NKT cells between the two groups (P> 0.05). Conclusion T cells and NKT cells are important components of cellular immunity in tuberculosis. NKT cells in patients with active tuberculosis only showed high expression, determination of peripheral blood NKT cells may be one of the tools to help diagnose active tuberculosis.