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目的:分析不同结核病患者外周血树突状细胞(DCs)及其亚群的变化,并进行免疫机制探讨。方法:就诊于我院2008-11/2009-08的结核病患者32例(实验组),同期在我院进行健康体检者11例(对照组),采用流式细胞术(FCM)检测了结核病患者(包括19例初治患者和13例复治患者,以及痰涂片结果不同的19例肺结核患者)和对照组中外周血中DCs及其亚群的变化。结果:实验组DC1亚群的比率和DCs的总数分别为(0.28±0.13)%和(0.42±0.19)%,明显低于对照组的DC1亚群的比率和DCs的总数(0.47±0.23)%和(0.65±0.22)%(P<0.01)。痰涂片阳性患者外周血中DC1亚群的比率和DCs的总数分别为(0.16±0.04)%和(0.24±0.06)%,明显低于痰涂片阴性患者DC1亚群的比率和DCs的总数(0.28±0.14)%和(0.43±0.12)%(P<0.05)。初治患者与复治患者外周血中DCs的总数及其亚群的比率无统计学意义(P>0.05)。结论:DCs可作为结核病传染源初筛和抗结核疗效观察的参考指标,反映不同结核病患者的免疫状态。
Objective: To analyze the changes of peripheral blood dendritic cells (DCs) and their subtypes in patients with different tuberculosis and to explore the mechanism of immune response. Methods: Totally 32 TB patients (experimental group) were enrolled in our hospital from November 2008 to August 2009 with 11 healthy controls in our hospital (control group). Flow cytometry (FCM) was used to detect tuberculosis patients (Including 19 untreated patients and 13 retreatment patients, as well as 19 cases of tuberculosis patients with different sputum smear results) and control group, and the changes of DCs and their subpopulations in peripheral blood. Results: The ratio of DC1 subpopulation and the total number of DCs in experimental group were (0.28 ± 0.13)% and (0.42 ± 0.19)%, respectively, which were significantly lower than those in control group (0.47 ± 0.23)% and DCs And (0.65 ± 0.22)% (P <0.01). The percentage of DC1 subpopulations and the total number of DCs in peripheral blood of sputum smear positive patients were (0.16 ± 0.04)% and (0.24 ± 0.06)%, respectively, which were significantly lower than those of sputum smear negative DC1 subpopulations and DCs (0.28 ± 0.14)% and (0.43 ± 0.12)%, respectively (P <0.05). There was no significant difference in the total number of DCs and their subsets between the newly diagnosed and retreated patients (P> 0.05). Conclusions: DCs can be used as a reference index for the screening of primary sources of TB infection and anti-TB efficacy, reflecting the immune status of different TB patients.