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目的：探讨肺结核病人Ｂ淋巴细胞活化状态。方法：采用间接酶联免疫吸附法（ＥＬＩＳＡ）及细胞－酶联标记法测定了５７例活动性肺结核病人特异性抗体分泌水平及外周血单个核细胞（ｐｅｒｉｐｈｅｒａｌｂｌｏｏｄｍｏｎｏｎｕｃｌｅａｒｃｅｌ，ＰＢＭＣ）ＣＤ２３、ＣＤ４０的表达。结果：（１）肺结核病人血清抗结素纯蛋白衍生物（ｐｕｒｉｆｉｅｄｐｒｏｔｅｉｎｄｅｒｉｖａｔｉｏｎ，ＰＰＤ）抗体ＩｇＧ、ＩｇＭ水平明显低于健康对照；病人离体培养的ＰＢＭＣ在无ＰＰＤ存在的条件下，所产生的ＩｇＧ抗体明显高于健康对照，而加入ＰＰＤ后ＩｇＧ抗体分泌水平与健康对照无差别。（２）肺结核病人当天未经培养的ＰＢＭＣＣＤ２３、ＣＤ４０的表达明显低于健康对照；病人ＰＢＭＣ经体外培养１０ｄ后，ＣＤ２３、ＣＤ４０的表达可明显提高；病人ＰＢＭＣ在加入ＰＰＤ刺激后，其ＣＤ２３的表达明显低于未加ＰＰＤ刺激组，二者存在密切相关。结论：肺结核病人特异性抗体分泌水平降低可能与其Ｂ淋巴细胞处于低活化状态有关。
Objective: To investigate the activation of B lymphocytes in patients with pulmonary tuberculosis. Methods: The levels of specific antibody secreted by 57 patients with active pulmonary tuberculosis and the expressions of CD23 and CD40 in peripheral blood mononuclear cells (PBMCs) were measured by indirect enzyme - linked immunosorbent assay (ELISA) and cell - enzyme linked immunosorbent assay (ELISA). Results: (1) The levels of IgG and IgM in patients with tuberculosis were significantly lower than those in healthy controls. The PBMCs cultured in vitro without PPD produced IgG antibodies Significantly higher than the healthy control, and after adding PPD IgG antibody secretion level and no difference between the healthy controls. (2) The expression of CD40 in PBMC CD23 was significantly lower than that in healthy controls on the day of tuberculosis. The expression of CD23 and CD40 in PBMC of patients with PBMC cultured in vitro for 10 days was significantly increased. The expression of CD23 Significantly lower than without PPD stimulation group, there is a close relationship between the two. Conclusion: The decrease of the secretion of specific antibody in patients with pulmonary tuberculosis may be related to the low activation of B lymphocytes.