支气管肺泡灌洗液腺苷脱氨酶及T细胞亚群在肺结核诊断中的应用价值(1)
[摘要] 目的 探讨支气管肺泡灌洗液腺苷脱氨酶(ADA)及T细胞亚群在肺结核诊断中的应用价值。 方法 选取2015年1月～2017年1月我院30例肺結核患者为观察组，另选取同期就诊的肺部良性病变患者30例为对照组。两组患者均行支气管肺泡灌洗，收集支气管肺泡灌洗液检测ADA及T淋巴细胞亚群。观察并比较两组患者的肺泡灌洗液ADA及T淋巴细胞亚群的差异。 结果 观察组患者支气管肺泡灌洗液ADA含量明显高于对照组，差异有统计学意义(P<0.05)；观察组患者支气管肺泡灌洗液T淋巴细胞CD3+、CD4+、CD4+/CD8+水平明显低于对照组，CD8+水平明显高于对照组，差异均有统计学意义(P<0.05或P<0.01)。 结论 肺结核患者免疫功能低下，检测支气管肺泡灌洗液ADA及T淋巴细胞亚群能为临床诊断肺癌提供依据，具有较高的临床应用价值。
[关键词] 肺结核；支气管肺泡灌洗液；腺苷脱氨酶；T淋巴细胞亚群
[中图分类号] R521 [文献标识码] B [文章编号] 1673-9701(2017)36-0124-04
[Abstract] Objective To investigate the application value of bronchoalveolar lavage fluid adenosine deaminase and T cell subsets in the diagnosis of pulmonary tuberculosis. Methods 30 patients with pulmonary tuberculosis from January 2015 to January 2017 were selected as the observation group. 30 patients with benign lung lesions in the same period were selected as the control group. Two groups of patients underwent bronchoalveolar lavage. The ADA and T lymphocyte subsets in the bronchoalveolar lavage fluid were collected. The differences of ADA and T lymphocyte subsets in the alveolar lavage fluid were observed and compared between the two groups. Results The ADA content of bronchoalveolar lavage fluid in the observation group was significantly higher than that in the control group， and the difference was significant(P<0.05). The levels of CD3+， CD4+， CD4+/CD8+ in T lymphocytes of bronchoalveolar lavage fluid in the observation group were significantly lower than those in the control group， and CD8+ level in the observation group was significantly higher than that in the control group， and the difference was statistically significant(P<0.05 or P<0.01). Conclusion Tuberculosis patients have low immune function. The detection of ADA and T lymphocyte subsets in bronchoalveolar lavage fluid can provide the basis for clinical diagnosis of lung cancer， and have high clinical application value.
[Key words] Tuberculosis； Bronchoalveolar lavage fluid； Adenosine deaminase； T lymphocyte subsets
肺结核是临床常见的呼吸道传染病，有研究显示全球有近1/3的患者感染过结核分枝杆菌，我国是结核病高发区域，患病率高、死亡率高[1-3]。早期诊断与治疗是改善肺结核患者预后的关键，找到结核杆菌是诊断肺结核的金标准，但临床上痰菌阴性的肺结核患者占总患者的65%～75%[4，5]。支气管肺泡灌洗术(bronchoalveolar lavage，BAL)是运用支气管镜对支气管以下肺段或亚肺段水平，反复以无菌生理盐水灌洗、回收，获得支气管肺泡灌洗液(bronchoalveolar lavage fluid，BALF)，从病原微生物学、分子生物学、免疫学、细胞学及酶学等角度检测分析BALF性质，近年来逐渐应用于早期诊断肺结核的诊断及治疗中[6-8]。本研究通过检测腺苷脱氨酶(adenosine deaminase，ADA)及T细胞亚群，探讨其对肺结核的诊断价值，现报道如下。
1 资料与方法
1.1 一般资料
选取2015年1月～2017年1月期间在我院就诊的肺结核患者共30例为观察组。纳入标准：根据痰液检查抗酸杆菌、病理学特征、影像学检查等确诊为肺结核。排除标准：(1)合并其他肺部疾病；(2)合并严重的循环系统、消化系统、血液系统疾病；(3)不愿接受支气管肺泡灌洗检测。其中男16例、女14例；年龄54～76岁，平均(63.7±5.7)岁。选取同期在我院门诊就诊的肺部良性病变患者30例作为对照组，其中男18例、女12例，年龄46～75岁，平均(64.3±6.1)岁，按肺部疾病分：慢性阻塞性肺疾病16例、支气管扩张8例、肺炎6例。两组患者在年龄构成、性别分布等方面比较差异无统计学意义(P>0.05)，具有可比性。本研究方案经我院伦理委员会批准通过，纳入的患者均知情同意，并签署知情同意书。, 百拇医药(朱凤娇 潘连连 王传捷 叶军辉)
[关键词] 肺结核；支气管肺泡灌洗液；腺苷脱氨酶；T淋巴细胞亚群
[中图分类号] R521 [文献标识码] B [文章编号] 1673-9701(2017)36-0124-04
[Abstract] Objective To investigate the application value of bronchoalveolar lavage fluid adenosine deaminase and T cell subsets in the diagnosis of pulmonary tuberculosis. Methods 30 patients with pulmonary tuberculosis from January 2015 to January 2017 were selected as the observation group. 30 patients with benign lung lesions in the same period were selected as the control group. Two groups of patients underwent bronchoalveolar lavage. The ADA and T lymphocyte subsets in the bronchoalveolar lavage fluid were collected. The differences of ADA and T lymphocyte subsets in the alveolar lavage fluid were observed and compared between the two groups. Results The ADA content of bronchoalveolar lavage fluid in the observation group was significantly higher than that in the control group， and the difference was significant(P<0.05). The levels of CD3+， CD4+， CD4+/CD8+ in T lymphocytes of bronchoalveolar lavage fluid in the observation group were significantly lower than those in the control group， and CD8+ level in the observation group was significantly higher than that in the control group， and the difference was statistically significant(P<0.05 or P<0.01). Conclusion Tuberculosis patients have low immune function. The detection of ADA and T lymphocyte subsets in bronchoalveolar lavage fluid can provide the basis for clinical diagnosis of lung cancer， and have high clinical application value.
[Key words] Tuberculosis； Bronchoalveolar lavage fluid； Adenosine deaminase； T lymphocyte subsets
肺结核是临床常见的呼吸道传染病，有研究显示全球有近1/3的患者感染过结核分枝杆菌，我国是结核病高发区域，患病率高、死亡率高[1-3]。早期诊断与治疗是改善肺结核患者预后的关键，找到结核杆菌是诊断肺结核的金标准，但临床上痰菌阴性的肺结核患者占总患者的65%～75%[4，5]。支气管肺泡灌洗术(bronchoalveolar lavage，BAL)是运用支气管镜对支气管以下肺段或亚肺段水平，反复以无菌生理盐水灌洗、回收，获得支气管肺泡灌洗液(bronchoalveolar lavage fluid，BALF)，从病原微生物学、分子生物学、免疫学、细胞学及酶学等角度检测分析BALF性质，近年来逐渐应用于早期诊断肺结核的诊断及治疗中[6-8]。本研究通过检测腺苷脱氨酶(adenosine deaminase，ADA)及T细胞亚群，探讨其对肺结核的诊断价值，现报道如下。
1 资料与方法
1.1 一般资料
选取2015年1月～2017年1月期间在我院就诊的肺结核患者共30例为观察组。纳入标准：根据痰液检查抗酸杆菌、病理学特征、影像学检查等确诊为肺结核。排除标准：(1)合并其他肺部疾病；(2)合并严重的循环系统、消化系统、血液系统疾病；(3)不愿接受支气管肺泡灌洗检测。其中男16例、女14例；年龄54～76岁，平均(63.7±5.7)岁。选取同期在我院门诊就诊的肺部良性病变患者30例作为对照组，其中男18例、女12例，年龄46～75岁，平均(64.3±6.1)岁，按肺部疾病分：慢性阻塞性肺疾病16例、支气管扩张8例、肺炎6例。两组患者在年龄构成、性别分布等方面比较差异无统计学意义(P>0.05)，具有可比性。本研究方案经我院伦理委员会批准通过，纳入的患者均知情同意，并签署知情同意书。, 百拇医药(朱凤娇 潘连连 王传捷 叶军辉)
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