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目的:探讨流式细胞技术检测恶性、结核性胸腔积液(PE)和外周血中T淋巴细胞亚型及比例的临床意义。方法:用流式细胞技术检测53例为结核性胸腔积液(PE)、62例为恶性积液患者和17例单纯性漏出液的胸水中的T淋巴细胞亚型及比例。结果:结核性胸腔积液患者胸水中淋巴细胞总数高于恶性胸腔积液或单纯漏出性胸腔积液患者(P=0.032),差异有统计学意义。亚型分析表明主要为T淋巴细胞,其中结核性和单纯漏出性胸腔积液的CD4+T细胞和CD4+/CD8+比值明显高于恶性胸腔积液(均为P<0.05),而恶性胸腔积液患者的CD8+T细胞则明显高于结核性和单纯漏出性胸腔积液的患者(P=0.006)。不同细胞亚型在结核性、恶性和单纯漏出性胸腔积液中无明显差别(P>0.05)。结论:结核性和单纯漏出性PE中CD4+T细胞和D4+/CD8+比值高于恶性肿瘤的患者,可作为鉴别诊断的参考。
Objective: To investigate the clinical significance of flow cytometry in the detection of T lymphocyte subsets and their proportion in malignant, tuberculous pleural effusion (PE) and peripheral blood. Methods: Flow cytometry was used to detect T lymphocyte subsets and their proportion in pleural effusion of 53 cases of tuberculous pleural effusion (PE), 62 cases of malignant effusion and 17 cases of simple effusion. Results: The total number of pleural effusion lymphocytes in patients with tuberculous pleural effusion was higher than that in patients with malignant pleural effusion or simple effusion (P = 0.032), the difference was statistically significant. Subtype analysis showed that T lymphocytes were predominant. Among them, the ratio of CD4 + T cells and CD4 + / CD8 + was significantly higher in tuberculous and simple leaky pleural effusion than in malignant pleural effusion (all P <0.05), whereas malignant pleural effusion Patients had significantly higher CD8 + T cells than tuberculous and simple leaky pleural effusions (P = 0.006). Different cell subtypes had no significant difference in tuberculous, malignant and simple leakage pleural effusion (P> 0.05). Conclusions: The ratio of CD4 + T cells and D4 + / CD8 + in patients with tuberculous and simple leaky PE is higher than that in malignant tumors and can be used as a reference for differential diagnosis.