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目的探讨肺结核(TB)患者外周血低密度粒细胞(LDGs)的比例变化及其意义。方法采用流式细胞术分析80例TB患者及25例健康体检者外周血单个核细胞(PBMCs)层中CD14~(low)CD15~+LDGs的比例及变化情况,检测LDGs表面CD15、CD16、CD33、CD66b、CD62L的表达水平、凋亡坏死率及ROS水平。分析LDGs与TB发生发展以及转归的相关性。结果 TB患者外周血PBMCs层中LDGs的比例显著高于健康对照组(P<0.01);痰涂片抗酸阳性的TB患者LDGs的比例显著高于抗酸阴性者(P<0.01)。与TB患者正常密度粒细胞(NDGs)比较,TB患者LDGs表面CD15、CD33、CD66b表达量显著升高,CD62L的表达量显著下降,凋亡率上调,ROS水平上调。LDGs的比例在肺部有无空洞及空洞数量分组之间差异有统计学意义(P<0.05),即LDGs的比例随空洞累及范围的增加而升高。TB患者经抗痨治疗后,外周血LDGs的比例随治疗时间延长而下降,治疗3个月后,LDGs的比例显著降低,治疗6个月后与健康对照组无明显差异。结论 LDGs水平在TB患者外周血中显著上调,TB患者外周血中的LDGs为一群发生脱颗粒的活化中性粒细胞,且与TB的严重程度相关。
Objective To investigate the changes of the proportion of peripheral blood low density granulocytes (LDGs) in patients with pulmonary tuberculosis (TB) and its significance. Methods The proportions and changes of CD14 ~ (low) CD15 ~ + LDGs in peripheral blood mononuclear cells (PBMCs) of 80 TB patients and 25 healthy controls were analyzed by flow cytometry. The expressions of CD15, CD16, CD33 , CD66b, CD62L expression level, apoptosis necrosis rate and ROS level. Analysis of LDGs and the occurrence and development of TB and the correlation. Results The proportion of LDGs in peripheral blood PBMCs of patients with TB was significantly higher than that of healthy controls (P <0.01). The proportion of LDGs in sputum smear-positive TB patients was significantly higher than that in acid-negative patients (P <0.01). Compared with normal density granulocytes (NDGs) of TB patients, the expression of CD15, CD33 and CD66b on the surface of LDGs in TB patients was significantly increased, the expression of CD62L was significantly decreased, the apoptosis rate was up-regulated and the level of ROS was up-regulated. There was a significant difference in the proportion of LDGs in the lungs between the groups with or without cavities (P <0.05), that is, the proportion of LDGs increased with the increase of the cavity coverage. After anti-TB treatment, the proportion of LDGs in peripheral blood decreased with the prolongation of treatment time. After 3 months of treatment, the proportion of LDGs was significantly reduced. After 6 months of treatment, there was no significant difference with the control group. Conclusions LDGs levels are significantly up-regulated in peripheral blood of patients with TB. LDGs in the peripheral blood of patients with TB are degranulated activated neutrophils and are related to the severity of TB.