摘要
目的:探讨肺结核及并发肺外结核患者淋巴细胞亚群的变化及其临床意义。方法:收集2019年1月1日至2023年1月1日在福建省福州肺科医院确诊的256例肺结核及75例肺结核并发肺外结核患者,对比肺结核与肺外结核组及其各亚组间外周血中淋巴细胞亚群绝对计数以判断其临床价值。结果:肺结核组患者CD3^(+)T淋巴细胞[902.50(608.25,1269.75)]、CD4^(+)T淋巴细胞[539.00(357.75,765.50)]、CD8^(+)T淋巴细胞[337.50(209.00,472.00)]、B细胞[159.00(82.00,257.50)]、NK细胞[160.00(88.50,244.50)]的数量均显著高于肺结核并发肺外结核组[729.50(468.25,975.50)]、[378.00(171.50,562.00)]、[276.00(152.00,412.00)]、[84.00(57.75,167.75)]、[128.00(51.00,192.00)],差异有统计学意义(Z=-3.074,P=0.002;Z=-4.488,P<0.0001;Z=-8.283,P=0.0341;Z=-2.954,P=0.003;Z=-2.115,P=0.034)。继发性肺结核组与其他亚组相比,CD3^(+)T淋巴细胞的数量[995.00(668.25,1409.75)]显著高于血行播散性肺结核组[709.50(391.00,975.00](Z=2.829,P=0.014)和继发性肺结核并发结核性胸膜炎组[764.00(527.25,1075.00)](Z=3.215,P=0.004)、继发性肺结核并发结核性脑膜炎[778.00(537.50,976.00)](Z=2.915,P=0.011)、继发性肺结核并发多种肺外结核[642.00(244.25,830.50)](Z=2.994,P=0.008)。CD4^(+)T淋巴细胞数量[604.00(384.50,853.00)]显著高于继发性肺结核并发结核性胸膜炎[485.00(309.00,641.00)](Z=2.684,P=0.022)、继发性肺结核并发结核性脑膜炎[378.00(181.50,571.50)](Z=3.780,P=0.0005)、继发性肺结核并发多种肺外结核[277.50(98.00,469.00)](Z=3.445,P=0.002)。CD8^(+)T淋巴细胞数量[382.50(227.75,496.25)]显著高于继发性肺结核并发结核性胸膜炎[273.00(170.25,406.25)](Z=2.995,P=0.008)。B细胞的数量[177.00(94.00,287.00)]显著高于血行播散性肺结核组[104.50(74.00,138.00)](Z=2.700,P=0.021)、继发性肺结核并发结核性胸膜炎组[132.00(66.00,200.00)](Z=2.761,P=0.017)、继发性肺结核并发多种肺外结核[75.00(55.50,115.75)](Z
Objective:This study aimed to investigate the alterations in peripheral blood lymphocyte subsets during the dissemination of secondary pulmonary tuberculosis and their clinical implications.Methods:Data were collected from 256 patients diagnosed with pulmonary tuberculosis and 75 with concurrent extrapulmonary tuberculosis between January 1,2019,and January 1,2023,at Fuzhou Pulmonary Hospital in Fujian Province.The absolute counts of peripheral blood lymphocyte subsets were compared between the pulmonary and extrapulmonary tuberculosis groups and among their respective subgroups to assess their clinical value.Results:Significantly higher amount of CD3^(+)T cells(902.50(608.25,1269.75)),CD4^(+)T cells(539.00(357.75,765.50)),CD8^(+)T cells(337.50(209.00,472.00)),B cells(159.00(82.00,257.50)),and NK cells(160.00(88.50,244.50))were observed in the pulmonary tuberculosis group compared to pulmonary tuberculosis combined with extrapulmonary tuberculosis group(729.50(468.25,975.50))、(378.00(171.50,562.00))、(276.00(152.00,412.00))、(84.00(57.75,167.75))、(128.00(51.00,192.00))(Z=-3.074,P=0.002;Z=-4.488,P<0.0001;Z=-8.283,P=0.034;Z=-2.954,P=0.003;Z=-2.115,P=0.03).The comparison between different subgroups show that:secondary pulmonary tuberculosis had significantly higher counts of CD3^(+)T cells(995.00(668.25,1409.75))than hematogenous disseminated pulmonary tuberculosis(709.50(391.00,975.00)(Z=2.829,P=0.014),secondary pulmonary tuberculosis combined with tuberculous pleurisy(764.00(527.25,1075.00))(Z=3.215,P=0.004),secondary pulmonary tuberculosis combined with tuberculous meningitis(778.00(537.50,976.00))(Z=2.915,P=0.011),and secondary pulmonary tuberculosis combined with multiple extrapulmonary tuberculosis(642.00(244.25,830.50))(Z=2.994,P=0.008).The number of CD4^(+)T cells(604.00(384.50,853.00))from secondary pulmonary tuberculosis was significantly higher than secondary pulmonary tuberculosis combined with tuberculous pleurisy(485.00(309.00,641.00))(Z=2.684,P=0.022),tuberculous meningitis(378.00(181.50,571.50)
作者
陈燕玲
吴迪
陈秀平
林宇君
陈晓红
Chen Yanling;Wu Di;Chen Xiuping;Lin Yujun;Chen Xiaohong(Department of Tuberculosis,Fuzhou Pulmonary Hospital,Fujian Province,Fuzhou 350008,China;Department of Pharmacy,Fujian Province Cancer Hospital,Fuzhou 350014,China)
出处
《结核与肺部疾病杂志》
2024年第4期294-304,共11页
Journal of Tuberculosis and Lung Disease
基金
福州市临床重点专科建设项目/福建省省级临床重点专科建设项目(20230104)。
关键词
结核
肺
免疫
细胞
淋巴细胞亚群
Tuberculosis,pulmonary
Immunity,cellular
Lymphocyte subsets
