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目的 研究结核性腹膜炎患者外周血及腹水T淋巴细胞亚群的变化 ,探讨其全身及局部免疫功能变化。方法 流式细胞仪测定 3 8例结核性腹膜炎治疗前、治疗后及 2 9例肝硬化并腹水患者、15例正常人的外周血和 (或 )腹水T淋巴细胞亚群。结果 ①结核性腹膜炎患者治疗前外周血T淋巴细胞 (CD3 + )、T辅助 /诱导淋巴细胞亚群 (CD4+ )、T辅助淋巴细胞 /T抑制淋巴细胞亚群 (CD4+ /CD8+ )较正常对照明显降低 (P <0 0 1) ,抗结核治疗后较治疗前升高 (P <0 0 1) ;②结核性腹膜炎患者腹水CD3 + 、CD4+ 、CD8+ 、CD4+ /CD8+ 显著高于肝硬化患者 (P <0 0 1) ,与外周血比较除CD8+ 降低 ,其余亦明显升高 (P <0 0 1)。结论 结核性腹膜炎患者外周血及腹水T淋巴细胞亚群存在明显异常 ,其免疫功能紊乱 ,表现为全身细胞免疫力低下而腹膜腔局部免疫力增强 ,T淋巴细胞亚群检测可作为结核性腹膜炎一项新的诊断指标
Objective To study the changes of T lymphocyte subsets in peripheral blood and ascites of patients with tuberculous peritonitis and to investigate the changes of systemic and local immune function. Methods Flow cytometry was used to detect T lymphocyte subsets in peripheral blood and / or ascitic fluid of 38 patients with tuberculous peritonitis before and after treatment, 29 patients with cirrhosis and ascites and 15 normal controls. Results ① Peripheral blood T lymphocyte (CD3 +), T helper / induced lymphocyte subsets (CD4 +) and T helper lymphocyte / T-suppressor lymphocyte subsets (CD4 + / CD8 +) in patients with tuberculous peritonitis before treatment were significantly higher than those in normal controls (P <0.01). The levels of CD3 +, CD4 +, CD8 + and CD4 + / CD8 + in ascites of patients with tuberculous peritonitis were significantly higher than those of patients with cirrhosis (P <0.01) <0 0 1). Compared with the peripheral blood, except CD8 + decreased, the rest were significantly increased (P <0 01). Conclusions T lymphocyte subsets in peripheral blood and ascites of patients with tuberculous peritonitis are obviously abnormal and their immune dysfunction is characterized by low systemic immunity and local immunity in peritoneal cavity. T lymphocyte subsets can be used as a marker of tuberculous peritonitis New diagnostic indicator