论文部分内容阅读
目的探讨耐药空洞型肺结核患者手术治疗前后外周血叉状头/翅膀状螺旋转录因子(forkhead/winged helixtranscription factor,Foxp3)表达阳性调节性T细胞(FoxP3~+regulatory T cells,Treg)水平改变。方法采用流式细胞术检测13例耐药空洞型肺结核患者手术治疗前后外周血淋巴细胞表面抗原CD4、CD25及胞浆内FoxP3的表达;同时以10例健康者外周血作为健康对照。结果耐药空洞型肺结核患者手术前外周血CD4~+、CD4~+CD25~-T细胞水平低于健康者(P<0.01);CD4~+CD25~+T细胞、CD4~+CD25~+FoxP3~+Treg细胞水平高于健康者(P<0.01)。与手术前比较,耐药空洞型肺结核患者手术治疗后1个月、6个月,CD4~+、CD4~+CD25~-T细胞水平升高,CD4~+CD25~+T细胞和CD4~+CD25~+FoxP3~+Treg细胞水平下降(P<0.01);手术治疗后6个月CD4~+CD25~+FoxP3~+Treg细胞水平较治疗后1个月下降(P<0.01)。结论耐药空洞型肺结核患者外周血CD4~+CD25~+FoxP3~+Treg细胞水平升高,有效手术治疗后下降。结核分枝杆菌可能通过诱导机体CD4~+CD25~+FoxP3~+Treg细胞增殖分化,从而产生免疫逃避。
Objective To investigate the changes of peripheral blood Forkhead / winged helix transcription factor (Foxp3) -positive regulatory T cells (Treg) before and after surgical treatment of patients with drug-resistant hollow-core tuberculosis. Methods Flow cytometry was used to detect the expression of CD4, CD25 and cytosolic FoxP3 in peripheral blood of 13 patients with drug-resistant empty-tuberculosis before and after surgery. Meanwhile, 10 healthy people were used as healthy controls. Results The levels of CD4 ~ + and CD4 ~ + CD25 ~ -T cells in peripheral blood of patients with drug-resistant empty-tuberculosis before surgery were significantly lower than those of healthy controls (P <0.01). CD4 ~ + CD25 ~ + T cells, CD4 ~ + CD25 ~ + FoxP3 ~ + Treg cells were higher than healthy controls (P <0.01). Compared with those before surgery, the levels of CD4 ~ + and CD4 ~ + CD25 ~ -T cells in CD4 ~ + CD25 ~ + T cells and CD4 ~ + T cells increased 1 month and 6 months after surgical treatment in patients with drug- (P <0.01). The levels of CD4 ~ + CD25 ~ + FoxP3 ~ + Treg cells decreased 6 months after surgery (P <0.01) compared with 1 month after treatment. Conclusions The levels of CD4 ~ + CD25 ~ + FoxP3 ~ + Treg cells in patients with drug-resistant empty-tuberculosis are increased, and they are decreased after effective operation. Mycobacterium tuberculosis may induce immune evasion by inducing the proliferation and differentiation of CD4 ~ + CD25 ~ + FoxP3 ~ + Treg cells.