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目的探讨复治肺结核患者外周血辅助性T细胞(T help,Th)17和调节性T细胞(Treg)在复治肺结核感染的临床意义。方法选取肺结核病患者89例,将其分成初治肺结核患者37例和复治肺结核患者52例。同时将52例复治肺结核患者根据痰找抗酸杆菌或痰分枝杆菌培养结果分成痰结核菌阳性组(30例)和阴性组(22例)。采用流式细胞分析法,检测各组外周血中Th17和Treg细胞占CD4+T细胞比例。结果复治肺结核组和初治结核患者外周血Th17细胞频率为分别为(1.28±0.16)%和(1.65±0.28)%,2组比较差异有统计学意义(t=2.71,P<0.05),2组Treg细胞表达水平分别为(7.34±1.51)%和(6.48±1.35)%,经统计分析差异有统计学意义(t=2.59,P<0.05)。痰菌阳性组Th17表达频率低于痰菌阴性组,差异无统计学意义(t=1.85,P>0.05),痰菌阳性组Treg细胞的表达百分率高于阴性组,但2组差异也无统计学意义(t=1.02,P>0.05)。结论复治肺结核患者的Th17细胞在CD4+T细胞中频率低于初治患者,Treg细胞频率高于初治患者,在复治结核病人的发病中能够发挥作用。
Objective To investigate the clinical significance of T helper 17 (T helper) and regulatory T (Treg) in the treatment of pulmonary tuberculosis in retreatment tuberculosis patients. Methods A total of 89 patients with tuberculosis were selected and divided into 37 newly diagnosed tuberculosis patients and 52 relapsed pulmonary tuberculosis patients. At the same time, 52 patients with re-treatment of pulmonary tuberculosis were divided into three groups: sputum bacterium (30 cases) and negative group (22 cases) according to sputum acid-fast bacilli or sputum mycobacteria culture results. Flow cytometry was used to detect the proportion of Th17 and Treg cells in CD4 + T cells in peripheral blood of each group. Results The frequency of Th17 cells in peripheral blood was 1.28 ± 0.16% and 1.65 ± 0.28% respectively in the retreatment group and the newly diagnosed tuberculosis group. There was significant difference between the two groups (t = 2.71, P <0.05) The levels of Treg cells in the two groups were (7.34 ± 1.51)% and (6.48 ± 1.35)%, respectively. There was statistically significant difference between the two groups (t = 2.59, P <0.05). The frequency of Th17 expression in sputum positive group was lower than that in sputum negative group (t = 1.85, P> 0.05). The positive rate of T17 in sputum positive group was higher than that in negative group, but there was no statistical difference between the two groups Significance (t = 1.02, P> 0.05). Conclusion The frequency of Th17 cells in patients with re-treatment of pulmonary tuberculosis in CD4 + T cells is lower than that in untreated patients. The frequency of Treg cells is higher than that in untreated patients and plays a role in the pathogenesis of retreatment tuberculosis.