摘要
目的分析儿童活动性结核病患者外周血T淋巴细胞亚群、B淋巴细胞及NK细胞的变化情况,并探讨其临床意义。方法采用流式细胞术检测106例活动性结核病患儿(结核病组)和106例健康儿童(健康对照组)外周血中T淋巴细胞亚群、B淋巴细胞及NK细胞比例并对比分析。结果结核病组患儿外周血CD3^(+)T、CD4^(+)T、NK细胞、CD4^(+)/CD8^(+)水平均显著低于健康对照组(Z=-3.783,P=0.000;Z=-5.401,P=0.000;Z=-3.434,P=0.001;Z=-2.014,P=0.044);双阴性T(DNT)细胞及B细胞水平均显著高于健康对照组(Z=2.765,P=0.006;Z=6.880,P=0.000);两组间CD8^(+)T及双阳性T(DPT)细胞水平差异无统计学意义(P>0.05)。不同年龄组(0~<3岁,3~<6岁,6~<10岁,10~<16岁)结核病患儿外周血淋巴细胞亚群表达水平不同,CD3^(+)T、DNT及B细胞在不同年龄组间表达水平差异有统计学意义(H=10.081,P=0.018;H=14.583,P=0.002;H=8.498,P=0.037)。肺外结核病组患儿外周血CD4^(+)T细胞水平低于肺内结核病组,差异有统计学意义(Z=-3.068,P=0.002),两组间其他指标差异无统计学意义(P>0.05)。结论结核病可导致患儿机体免疫功能明显紊乱,动态监测结核病患儿外周血淋巴细胞亚群变化能更好地评估免疫状态,有助于指导临床个性化治疗。
Objective To analyze the changes in T lymphocyte subsets,B lymphocytes and NK cells in children with active tuberculosis(TB)and their clinical significance.Methods T lymphocyte subsets,B lymphocytes and NK cells in peripheral blood samples of 106 patients with acute TB(TB group)and 106 healthy children(healthy control group)were detected by flow cytometry and compared between different groups.Results The percentages of CD3^(+)T,CD4^(+)T and NK cells as well as the CD4^(+)/CD8^(+)T cell ratio were significantly lower in the TB group than in the healthy control group(Z=-3.783,P=0.000;Z=-5.401,P=0.000;Z=-3.434,P=0.001;Z=-2.014,P=0.044).The percentages of double negative T(DNT)and B cells in the TB group were significantly higher than those in the healthy control group(Z=2.765,P=0.006;Z=6.880,P=0.000).No significant difference in the percentage of CD8^(+)T or double positive T(DPT)cells was observed between the two groups(P>0.05).The expression of peripheral lymphocyte subsets varied in TB children of different age groups(0-<3,3-<6,6-<10 and 10-<16 years old).There were significant differences in CD3^(+)T,DNT and B cells among the four age groups(H=10.081,P=0.018;H=14.583,P=0.002;H=8.498,P=0.037).The percentage of CD4^(+)T cells was significantly lower in children with extrapulmonary TB than in those with pulmonary TB(Z=-3.068,P=0.002).No statistically significant difference in other lymphocyte subsets was found between children with extrapulmonary and pulmonary TB(P>0.05).Conclusions Tuberculosis could lead to immune dysfunction in children.Dynamic monitoring of the changes in peripheral lymphocyte subsets in children with TB could be conducive to better assessment of immune status and providing personalized treatment.
作者
杨硕
严小桐
刘腾
赵梦川
刘泽昊
李贵霞
冯志山
王乐
Yang Shuo;Yan Xiaotong;Liu Teng;Zhao Mengchuan;Liu Zehao;Li Guixia;Feng Zhishan;Wang Le(Institute of Pediatric Research,Hebei Children′s Hospital Affiliated to Hebei Medical University,Shijiazhuang 050031,China;Department of Laboratory Medicine,Hebei Children′s Hospital Affiliated to Hebei Medical University,Shijiazhuang 050031,China;Department of Laboratory Medicine,Hebei General Hospital,Shijiazhuang 050057,China)
出处
《中华微生物学和免疫学杂志》
CAS
CSCD
北大核心
2021年第1期30-35,共6页
Chinese Journal of Microbiology and Immunology
基金
河北省2017年度医学科学研究重点课题计划 (20170404)。
