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目的观察耐多药结核(MDR-TB)患者外周血辅助性T(Th)17细胞的水平,探讨人体抵抗MDR-TB的免疫学机制。方法选取MDR-TB患者25例(MDR-TB组),初治肺结核患者23例(TB组),健康正常人25例(HC组)。采用流式细胞分析法检测各组人群外周血Th17细胞占CD4+T细胞比例。应用流式微球分析法检测各组人群外周血Th17相关的白细胞介素(IL)17和IL-6的表达。结果 MDR-TB组和TB组患者外周血Th17/CD4+T细胞比例分别为(2.18±0.65)%和(1.32±0.34)%,明显高于HC组的(0.41±0.10)%(P<0.05);MDR-TB组的Th17细胞比例亦高于TB组(P<0.05)。MDR-TB组和TB组患者外周血IL-17水平分别为(6.45±1.88)pg/ml和(3.53±0.38)pg/ml,明显高于HC组的(2.39±0.46)pg/ml(P<0.05);MDR-TB和TB组间差异亦有统计学意义(P<0.05)。MDR-TB组患者外周血IL-6水平为(571.70±188.24)pg/ml,明显高于TB组的(18.50±5.87)pg/ml和HC组的(5.76±1.86)pg/ml(P<0.05)。三组外周血IL-17水平与IL-6水平呈正相关(r=0.824,P<0.01)。结论 MDR-TB患者外周血Th17细胞比例增加,IL-17I、L-6水平升高。Th17细胞可能参与MDR-TB的发病。
Objective To observe the levels of peripheral blood T helper 17 (Th17) cells in patients with multidrug-resistant tuberculosis (MDR-TB) and explore the immunological mechanism of human MDR-TB resistance. Methods Twenty-five MDR-TB patients (MDR-TB group), 23 newly diagnosed tuberculosis patients (TB group) and 25 healthy controls (HC group) were selected. Flow cytometry was used to detect the proportion of Th17 cells in CD4 + T cells in peripheral blood of each group. Flow cytometry was used to detect the expression of Th17-related interleukin (IL) 17 and IL-6 in peripheral blood of each group. Results The proportion of Th17 / CD4 + T cells in peripheral blood of MDR-TB group and TB group was (2.18 ± 0.65)% and (1.32 ± 0.34)%, respectively, which was significantly higher than that of HC group (0.41 ± 0.10)% ). The proportion of Th17 cells in MDR-TB group was also higher than that in TB group (P <0.05). The levels of IL-17 in peripheral blood of MDR-TB group and TB group were (6.45 ± 1.88) pg / ml and (3.53 ± 0.38) pg / ml respectively, which were significantly higher than those of HC group (2.39 ± 0.46 pg / <0.05). The difference between MDR-TB group and TB group was also statistically significant (P <0.05). The levels of IL-6 in MDR-TB group were (571.70 ± 188.24) pg / ml, which were significantly higher than those in TB group (18.50 ± 5.87) pg / ml and HC group (5.76 ± 1.86) pg / 0.05). There was a positive correlation between IL-17 level and IL-6 level in the three groups (r = 0.824, P <0.01). Conclusion The proportion of Th17 cells in peripheral blood of patients with MDR-TB increased, and the levels of IL-17I and L-6 increased. Th17 cells may be involved in the pathogenesis of MDR-TB.