论文标题:初治骨关节结核患者外周血T淋巴细胞亚群特点及其临床意义的研究
The Characters and Clinical Significance of T Lymphocyte Subsets in Peripheral Blood of New Cases with Osteoarticular Tuberculosis
论文作者 管波清
论文导师 林羽；吴启秋,论文学位 硕士,论文专业 骨科
论文单位 北京市结核病胸部肿瘤研究所,点击次数 87,论文页数 70页File Size3364k
2005-06-13论文网 http://www.lw23.com/lunwen_915855462/ 骨关节结核;T淋巴细胞亚群;细胞免疫;CD4阳性T淋巴细胞;CD8阳性T淋巴细胞
tuberculosis, osteoarticular; T-lymphocyte subsets; cell-mediated immunity; CD4-positive T-lymphocyte; CD8-positive T-lymphocyte
目的:通过检测外周血T淋巴细胞亚群,探讨骨关节结核患者细胞免疫特点及T淋巴细胞亚群细胞水平与临床指标的关系;通过观察骨关节结核患者抗结核治疗1月后T淋巴细胞亚群水平变化情况,初步探讨抗结核治疗对骨关节结核患者机体细胞免疫的作用;为临床工作中正确评价初治骨关节结核患者外周血T淋巴细胞亚群检测结果,提供依据。 方法:采用单平台流式细胞术,检测初治骨关节结核患者治疗前外周血T淋巴细胞亚群绝对数及百分数,并与恶性骨肿瘤患者及健康对照的外周血T淋巴细胞亚群进行比较;分析初治骨关节结核患者的各项临床指标与外周血T淋巴细胞亚群的关系;同时配对比较初治骨关节结核患者治疗前与治疗1月后外周血T淋巴细胞亚群的变化。 结果:共有52例初治骨关节结核、18例恶性骨肿瘤及52例健康对照纳入本研究。初治骨关节结核组外周血CD45~+淋巴细胞、CD3~+T淋巴细胞、CD4~+T淋巴细胞及CD8~+T淋巴细胞的绝对数较健康对照组低,差异有显著性。骨关节结核组的CD45~+淋巴细胞计数、CD3~+T淋巴细胞计数、CD4~+T淋巴细胞计数、CD8~+T淋巴细胞计数较恶性骨肿瘤组低,差异有显著性(P<0.01)。26例骨关节结核患者CD3%及CD8%在治疗1月后下降,差异显著(P<0.05)。青年组CD8~+T淋巴细胞绝对值、CD8%显著高于中年组及老年组(P<0.05,P<0.01),CD4/CD8比值青年组显著低于中年组及老年组(P<0.01);CD3%在青年组显著高于老年组(P<0.05)。初治脊柱结核并发脓肿者24例,无脓肿形成者12例;二组T淋巴细胞亚群比较,脊柱结核并发脓肿者CD4/CD8比值较低,CD8%较高,有显著性差异(P<0.01)。T淋巴细胞亚群细胞水平与PPD反应直径、病程、血沉及C反应蛋白之间无显著相关性(P>0.05)。脊柱结核组与外周关节结核组间T淋巴细胞亚群无显著差异(P>0.05)。脊柱结核瘫痪组与无瘫痪组间T淋巴细胞亚群无显著差
Objectives: to investigate the features, changes of T lymphocyte subsets of new cases with osteoarticular tuberculosis before and after antituberculosis treatment and to investigate their correlations to clinical factors. To provide basis for clinical work for correctly evaluating the lymphocyte subset values in peripheral blood of new cases with osteoarticular tuberculosis.Methods: both absolute counts and percentages of lymphocyte subsets in peripheral blood of new cases with osteoarticular tuberculosis were detected by single-plateform flow cytometry. T lymphocyte subsets in Peripheral Blood of new cases with osteoarticular tuberculosis were compared with those from 18 patients with malignant primary or metastatic bone tumor and 52 normal controls. The correlations of T lymphocyte subsets values of peripheral blood to several clinical factors of new cases with osteoarticular tuberculosis were analyzed. The T lymphocyte subsets values in peripheral blood of patients with osteoarticular tuberculosis between pre-treatment and one month post-treatment were compared.Results: fifty-two new cases with osteoarticular tuberculosis, eighteen patients with malignant primary or metastatic bone tumor and fifty-two normal controls wererecruited. The levels of absolute counts of CD45+, CD3+, CD4+ and CD8+ cells in new cases with osteoarticular tuberculosis were significantly lower than those in normal controls and in malignant bone tumors. The levels of absolute counts andpercentage of CD8+ T lymphocytes in adolescent patients were significantly higher than those in middleaged and elderly patients. The levels of percentage of CD3+
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