儿童肺结核患者支气管肺泡灌洗液免疫细胞检测与分析

doi:10.19871/j.cnki.xfcrbzz.2023.01.003

新发传染病电子杂志 ›› 2023, Vol. 8 ›› Issue (1): 14-18.doi: 10.19871/j.cnki.xfcrbzz.2023.01.003

儿童肺结核患者支气管肺泡灌洗液免疫细胞检测与分析

李金沛¹, 叶涛生¹, 徐宇翔¹, 曾旋¹, 刘志超², 杨倩婷³

1.深圳市第三人民医院呼吸内镜室,广东深圳 518112;
2.深圳市第三人民医院肺病三科,广东深圳 518112;
3.深圳市第三人民医院肝病研究所,国家感染性疾病临床医学研究中心,广东深圳 518112

收稿日期:2022-04-09 出版日期:2023-02-28 发布日期:2023-03-30
通讯作者: 杨倩婷,Email：569203197@qq.com
基金资助:
1.国家自然面上项目（82172286）; 2.深圳市科技计划项目（JCYJ20210324131603008）

Detection and analysis of immune cells in bronchoalveolar lavage fluid of child patients with pulmonary tuberculosis

Li Jinpei, Ye Taosheng, Xu Yuxiang, Zeng Xuan, Liu Zhichao, Yang Qianting

1. Department of Respiratory Endoscopy, The Third People's Hospital of Shenzhen, Guangdong Shenzhen 518112, China;
2. Department of Pulmonary Medicine & Tuberculosis, The Third People's Hospital of Shenzhen, Guangdong Shenzhen 518112, China;
3. Institute for Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Guangdong Shenzhen 518112, China

Received:2022-04-09 Online:2023-02-28 Published:2023-03-30

摘要/Abstract

摘要： 目的采用流式细胞仪检测肺结核患者支气管肺泡灌洗液淋巴细胞亚群,探讨肺结核患者支气管肺泡灌洗液淋巴细胞免疫功能状态的变化。方法选取19例儿童肺结核患者作为观察组,根据痰涂片结果分为菌阳组（11例）和菌阴组（8例）。同期选取就诊的21例成人肺结核患者作为对照组。通过流式细胞术对其进行检测,检测两组研究对象的支气管肺泡灌洗液T淋巴细胞、CD4⁺T淋巴细胞、CD8⁺T淋巴细胞、单核细胞和B淋巴细胞比例的变化,并比较其差异性。结果儿童肺结核患者的支气管肺泡灌洗液中各免疫细胞的比例分别为：T淋巴细胞（54.57±5.28）%、CD4⁺T淋巴细胞（66.14±4.08）%、CD8⁺T淋巴细胞（33.80±4.07）%和B淋巴细胞（13.54±2.53）%与成人肺结核患者的T淋巴细胞（53.30±4.76）%、CD4⁺T淋巴细胞（65.45±3.49）%、CD8⁺T淋巴细胞（34.55±3.49）%和B淋巴细胞（14.70±2.83）%比较,两组差异均无统计学意义（P>0.05）。两组肺结核患者的CD4⁺/CD8⁺T淋巴细胞比例均差异无统计学意义（P>0.05）。儿童肺结核患者的单核细胞（16.00±3.20）%与成人肺结核患者（9.25±1.17）%比较,显著性增高,两者差异有统计学意义（P<0.05）。菌阳组支气管肺泡灌洗液中CD4⁺T淋巴细胞（65.64±5.41）%、CD8⁺T淋巴细胞（34.36±5.41）%和单核细胞（19.15±5.18）%与菌阴儿童结核患者CD4⁺T淋巴细胞（66.84±6.65）%、CD8⁺T淋巴细胞（33.03±6.58）%和单核细胞（11.75±1.75）%比较,差异均无统计学意义（P>0.05）。但菌阳组T淋巴细胞（45.06±6.38）%和B淋巴细胞（9.30±2.60）%显著低于菌阴组[分别为（67.64±6.93）%和（21.48±4.17）%],差异有统计学意义（P<0.05）。结论儿童肺结核患者的单核细胞高于成人肺结核患者;痰涂片细菌阳性的儿童结核患者B淋巴细胞的比例显著低于痰涂片细菌阴性患者。提示在活动性儿童结核患者的免疫功能有所下降,为了解肺结核的发病机制及为临床免疫治疗提供一定的理论依据。

关键词: 肺结核, 儿童结核, 支气管肺泡灌洗液, 细胞免疫, 免疫细胞

Abstract: Objective To investigate the changes of lymphocyte immune function of pulmonary alveolar lavage fluid (BALF) in patients with pulmonary tuberculosis by flow cytometry. Method 19 pediatric tuberculosis patients were enrolled, according to sputum smear results, they were divided into bacteria positive group (11 cases) and bacteria negative group (8 cases). 21 adult tuberculosis patients were selected as the control group. Flow cytometry was used to detect the changes in the proportion of lymphocytes, CD4⁺T cells, CD8⁺T cells, monocytes and B lymphocytes in Balf of the two groups, and the differences were compared. Result The proportion of immune cells in Balf of children with tuberculosis was as follow: The proportion of T lymphocytes was (54.57±5.28)%, CD4⁺T cells (66.14±4.08)%, CD8⁺T cells (33.80±4.07)% and B cells (13.54±2.53)% pediatric tuberculosis patients. The proportion of T lymphocytes was (53.30±4.76)%, CD4⁺T cells (65.45±3.49)%, CD8⁺T cells (34.55±3.49)% and B cells (14.70±2.83)% in adult pulmonary tuberculosis patients. There was no statistical significance between the two groups (P>0.05). There was no difference in the ratio of CD4⁺/CD8⁺T cells between two groups (P>0.05). The monocytes of children tuberculosis patients (16.00±3.20)% were significantly higher than those of adult tuberculosis patients (9.25±1.17), and the difference was statistically significant (P<0.05). The proportion of CD4⁺T lymphocyte was (65.64±5.41)%, CD8⁺T lymphocyte （34.36±5.41）% and monocyte (19.15±5.18)% in the Balf of the positive of bacteriology subgroup of pediatric tuberculosis patients. The proportion of CD4⁺T lymphocyte was (66.84±6.65)% , CD8⁺T lymphocyte (33.03±6.58)% and monocyte (11.75±1.75)% in the negative of bacteriology subgroup of pediatric tuberculosis patients. There was no statistical significance (P>0.05). However, The proportion of T lymphocyte was (45.06±6.38)% and B cells (9.30±2.60)% in positive of bacteriology subgroup were significantly lower than those in the negative group [(67.64±6.93)% and (21.48±4.17)%], respectively, and the difference was statistically significant (P<0.05). Conclusion Monocytes from pediatric patients with pulmonary tuberculosis were higher than those in adult pulmonary tuberculosis patients;The proportion of B lymphocytes in pediatric TB patients with sputum smear bacteria positive was significantly lower than in sputum smear bacteria negative patients. It suggests that the immune function of active children with tuberculosis has decreased, which provides some theoretical basis for understanding the pathogenesis of pulmonary tuberculosis and for clinical immunotherapy.

Key words: Tuberculosis, Children with tuberculosis, Bronchoalveolar lavage fluid, Cellular immunity, Immune cells

中图分类号:

李金沛, 叶涛生, 徐宇翔, 曾旋, 刘志超, 杨倩婷. 儿童肺结核患者支气管肺泡灌洗液免疫细胞检测与分析[J]. 新发传染病电子杂志, 2023, 8(1): 14-18.

Li Jinpei, Ye Taosheng, Xu Yuxiang, Zeng Xuan, Liu Zhichao, Yang Qianting. Detection and analysis of immune cells in bronchoalveolar lavage fluid of child patients with pulmonary tuberculosis[J]. Electronic Journal of Emerging Infectious Diseases, 2023, 8(1): 14-18.

参考文献

[1] 焦伟伟. 儿童结核病分子生物学诊断方法研究进展[J]. 结核与肺部疾病杂志, 2021, 2(1): 69-71.
[2] 中国医师协会儿科医师分会风湿免疫专业委员会, 中国医师协会儿科医师分会过敏专业委员会, 中华医学会儿科分会免疫学组, 流式细胞术分析外周血淋巴细胞亚群在儿科的临床应用共识[J]. 中华检验医学杂志, 2016, 39(5): 344-349.
[3] 中华人民共和国国家卫生和计划生育委员会. 肺结核诊断标准(WS 288–2017)[J/CD].新发传染病电子杂志,2018,3(1):59-61.
[4] 卢春容,房宏霞,陆普选,等. 2021 WHO全球结核病报告:全球与中国关键数据分析[J/CD]. 新发传染病电子杂志,2021, 6(4):368-372.
[5] WORLD HEALTH ORGANIZATION.Global tuberculosis report 2022[EB/OL]. https://www.who.int/teams/global tuberculosis-programme/tb-reports/global-tuberculosisreport-2022.
[6] ZINK AR, SOLA C, REISH1 U, et al. Characterization of Mycobscterium tuberculosis complex DNAs from Egptian mummies by spoligotying[J]. J Clin Microbiol, 2003, 41(1): 359-367.
[7] 何晗, 唐柳生, 李世立, 等. 青年肺结核患者支气管肺泡灌洗液T淋巴细胞亚群及炎症因子测定价值分析[J]. 右江医学, 2020, 48(9): 686-689.
[8] 庞增, 何日东, 陈勇军, 等. 不同治疗时期肺结核患者T淋巴细胞亚群的动态变化及临床意义[J]. 现代医院, 2018, 18(4): 543-545.
[9] 钟国庆, 杨庆平. T淋巴细胞亚群联合Th1/Th2细胞因子诊断肺结核患的应用价值分析[J]. 中国实验诊断学, 2018, 22(5): 830-831.
[10] 米洁, 薛勇, 白雪娟, 等. 淋巴细胞检测在肺结核诊疗中的研究进展[J]. 中国防痨杂志, 2021, 43(2): 178-185.
[11] 尤英霞, 闫莎莎, 黄庆红, 等. 肺结核患者肺泡灌洗液及外周血中T淋巴细胞亚群的表达[J]. 中国实验诊断学, 2017, 21(9): 1561-1562.
[12] LEWINSOHN DA, HEINZEL AS, GARDNER JM, et al.Mycobacterium tuberculosis-specific CD8+T cells preferential preferentially recognize heavily infected cells[J]. Am J Respir Crit Care Med, 2003, 168(11): 1346-1352.
[13] 朱春玲, 侯远沛, 尤莲,等. 肺结核患者外周血免疫细胞水平与临床意义分析[J]. 中国人兽共患病学报, 2018, 34(7): 648-652.
[14] RAO M, VALENTINI D, POIRET T, et al.B in TB: B Cells as Mediators of Clinically Relevant Immune Responses in Tuberculosis[J]. Clin Infect Dis, 2015, 61:S225-234.
[15] Khan A, Singh VK, Hunter RL. Jagannath C.Macrophage heterogeneity and plasticity in tuberculosis[J]. J Leukoc Biol, 2019, 106(2):275-282.

儿童肺结核患者支气管肺泡灌洗液免疫细胞检测与分析

Detection and analysis of immune cells in bronchoalveolar lavage fluid of child patients with pulmonary tuberculosis

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	任坦坦, 詹森林, 张培泽, 汤全珍, 徐正富, 王凌伟, 付亮, 邓国防. 慢性肾脏病患者并发结核病临床特点分析[J]. 新发传染病电子杂志, 2023, 8(1): 52-55.
[2]	李同霞, 褚晏, 林梅, 李菁, 王丙瑞, 马广仁. 6765例结核分枝杆菌培养阳性肺结核患者耐药及共病分析[J]. 新发传染病电子杂志, 2022, 7(4): 12-15.
[3]	桂静, 杨慧, 傅钰, 刘涛. 血糖血脂异常对肺结核合并2型糖尿病的影响分析[J]. 新发传染病电子杂志, 2022, 7(4): 37-41.
[4]	符雄, 符林琳, 符秋叶, 吴伟珍. T细胞斑点试验与痰涂片检查在成人不同年龄段肺结核诊断中的结果分析[J]. 新发传染病电子杂志, 2022, 7(4): 53-56.
[5]	王晓霞, 梁瑞云, 钟鹏. 儿童甲状腺癌肺转移误诊血行播散性肺结核3例报道[J]. 新发传染病电子杂志, 2022, 7(4): 82-85.
[6]	付寒, 王鹏, 张宗华, 季乐财. 标准抗结核治疗方案对耐多药肺结核患者肾功能的影响分析[J]. 新发传染病电子杂志, 2022, 7(3): 32-36.
[7]	郑广平, 罗杰棋, 鲍晓慧, 陆普选, 魏方军. 肠结核的临床影像诊断及与克罗恩病的鉴别诊断[J]. 新发传染病电子杂志, 2022, 7(3): 90-94.
[8]	张娟娟, 王云霞, 胡方祥, 黄佩佩, 刘振扬, 梅金周, 袁青. 自回归移动平均模型在深圳市宝安区结核病疫情预测中的应用[J]. 新发传染病电子杂志, 2022, 7(1): 47-51.
[9]	张小其, 李敏璐, 刘靖元. 互联网+视频服药APP督导方式在肺结核患者治疗管理中的应用效果[J]. 新发传染病电子杂志, 2022, 7(1): 66-69.
[10]	陈思宇, 白兰, 张锦. HBeAg状态对HBV/TP重叠感染患者细胞免疫功能的分析[J]. 新发传染病电子杂志, 2021, 6(4): 298-301.
[11]	杨梁梓, 任坦坦, 傅向东, 刘智, 罗蓝, 张培泽. 含贝达喹啉新方案治疗耐药肺结核的疗效与安全性研究[J]. 新发传染病电子杂志, 2021, 6(4): 302-305.
[12]	黎惠如, 方伟军, 刘曾维, 谢智恩. CT在单发结节或肿块型肺结核和肺癌鉴别中的作用研究[J]. 新发传染病电子杂志, 2021, 6(4): 323-326.
[13]	谭运彩, 袁媛, 杨双喜, 杨雪. 二甲双胍与2型糖尿病患者肺结核感染风险的倾向性评分匹配分析[J]. 新发传染病电子杂志, 2021, 6(3): 202-205.
[14]	中华医学会放射学分会传染病放射学组, 中国医师协会放射医师分会感染影像专业委员会, 中国研究型医院学会感染与炎症放射专业委员会, 中国性病艾滋病防治协会感染（传染病）影像工作委员会, 中国医院协会传染病分会传染病影像学组, 北京影像诊疗技术创新联盟. 肺结核影像诊断标准[J]. 新发传染病电子杂志, 2021, 6(1): 1-6.
[15]	方伟军, 韩远远, 宋敏, 刘文, 刘志辉. 陈旧性肺结核复燃的CT征象分析[J]. 新发传染病电子杂志, 2021, 6(1): 45-48.