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复治痰菌阴性肺结核患者支气管肺泡灌洗液的检测(1)
http://www.100md.com 2008年3月1日 《人人健康·医学导刊》 2008年第3期
     【摘要】目的:探讨肺结核在同一患者肺部感染部位的差异。方法 随机选取我科一侧肺部正常的复治肺结核患者20例,每例均痰涂片找抗酸杆菌>3次阴性。①取治疗前外周血标本和治疗后2个月外周血标本查CD3、CD4、CD8、NK细胞及CD4/CD8 比值;②选取病变累及的肺段作为灌洗部位,同时选中对侧没有病变的肺段作为对照。取灌洗液查CD3、CD4、CD8、NK细胞及CD4/CD8 比值,同时取灌洗液找抗酸杆菌和结核菌培养。结果 病变累及的肺段支气管肺泡灌洗液中CD3T细胞明显低于没有病变累及的肺段组,CD4T细胞、CD4/CD8、NK细胞明显低于病变没有累及的对侧肺段组。抗结核治疗2个月后CD3、CD4/CD8 比值较治疗前明显上升,CD4、CD8T细胞治疗前后差异无显著, NK细胞治疗前后明显上升。结论 复治痰菌阴性肺结核患者肺部正常与不正常部位存在CD3、CD4、NK细胞和CD4/CD8比值不同同局部细胞免疫功能有关。

    【关键词】肺结核;流式细胞术;T淋巴细胞亚群;支气管肺泡灌洗
, 百拇医药
    Duplicate will govern the phlegm fungus negative pulmonary tuberculosis patient bronchial tube pulmonary alveolus to fill the cleaning solution the examination

    PAN Hong-qiu CHEN Yong-zhong YAN Jin-er et al.

    【Abstract】Objeetive:The discussion pulmonary tuberculosis infects the spot in the identical patient lungs the difference. The method stochastically selects my branch side lungs to be normal duplicate governs the pulmonary tuberculosis patient 20 examples, each example even phlegm spreads the piece to look for the acid-proof bacillus 3 negative.①Takes before the treatment peripherythe blood specimen and treats the latter 2 months periphery blood specimen to look up CD3, CD4, CD8, the NK cell and CDthe 4/CD8 ratios; ②The selection pathological change implicates the lung section achievement fills washes the spot, simultaneously selects the opposite side not to have the pathological change the lung section achievement comparison. Takes fills the cleaning solution to look up CD3, CD4, CD8, the NK cell and CDthe 4/CD8 ratios, simultaneously takes fills the cleaning solution to look for the acid-proof bacillus and the tuberculosis fungus raise. Finally the pathological change implicates the lung section bronchial tube pulmonary alveolus fills in the cleaning solution CD3 T cell obviously to be lower than does not have the lung section group which the pathological change implicates, CD4 T cell, CD4/CD8, the NK cell obviously to be lower than the opposite side lung section group which the pathological change has not implicated. Before the anti-tuberculosis treats for 2 months CD3, CDthe 4/CD8 ratios comparatively treats obviously rises, CD4, CDaround 8 T cell treatment the difference is not remarkable, around the NK cell treatment obviously rises. The conclusion duplicate governs the phlegm fungus negative pulmonary tuberculosis patient lungs normally to have CD with not the normal spot3, CD4, the NK cell and CDthe 4/CD8 ratios differently concerns with the partial cellular immunity function.
, 百拇医药
    【Key words】Pulmonary tuberculosis; Flows the type cell technique; T lymphocyte subgroup; The bronchial tube pulmonary alveolus fills washes

    结核病的主要免疫保护机制是细胞免疫,体液免疫对控制结核分枝杆菌感染的作用不重要。[1]近年来,随着细胞和分子免疫学的进展,人们已充分认识到CD4及CD8T细胞在结核病免疫发病中的重要作用。通过分析复治痰菌阴性肺结核同一患者肺部正常与不正常部位是否存在CD3、CD4、CD8、NK细胞含量不同,探讨肺结核在同一患者肺部感染部位差异的原因。

    1 对象与方法

    1.1 研究对象:为1997年7月~2006年5月期间我院患者20例。其中男12例,女8例年龄20~70岁,平均52岁。病例要求①结核中毒症状较轻。②X线检查及CT 检查发现结核病灶,并提示结核活动;病灶为单侧。③既往用药时间大于1个月的复发病例。④均为痰结核菌涂片阴性>3次。

    1.2 方法

    1.2.1 标本采集:外周血标本:采治疗前、治疗2个月后空腹血各5mk,肝素抗凝后立即送检。, 百拇医药
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