本文選題：脊柱結(jié)核 + T淋巴細胞亞群��； 參考：《昆明醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：通過檢測脊柱結(jié)核患者外周血中T淋巴細胞亞群、細胞因子IFN-γ和IL-4在病程中不同時間點的變化,探討脊柱結(jié)核患者機體免疫力變化的規(guī)律,為脊柱結(jié)核的個體化治療方案的制定和調(diào)整提供一定的依據(jù)。 材料和方法：采用單平臺流式細胞技術(shù),檢測納入病例組的51例初治患者外周血中T淋巴細胞亞群(CD3+、CD4+、CD8+、CD19+和NK)細胞的絕對數(shù)和百分數(shù),并與健康對照組的相應(yīng)指標進行比較；對其中36例進行手術(shù)治療并于術(shù)后1-3天內(nèi)完成T細胞亞群檢測的病例進行術(shù)前和術(shù)后對比分析；對術(shù)后1月按時復(fù)診的病例也進行相同的檢測,與治療前的T細胞亞群水平進行對比分析。上述病例中提取單個核細胞時獲取的血漿樣本低溫保存,采用流式細胞技術(shù)進行IFN-γ和IL-4與蛋白水平檢測,并與上述相應(yīng)的時間點進行對比分析。 結(jié)果：本組脊柱結(jié)核患者病例中,CD3+T淋巴細胞和CD4+T淋巴細胞絕對數(shù)和百分數(shù)均低于健康對照組,組間比較差別有統(tǒng)計學(xué)意義(P0.05)；而CD8+T、 CD19+和NK細胞的絕對數(shù)和百分數(shù)與健康對照組件比較無統(tǒng)計學(xué)差(P0.05)。手術(shù)前后組間比較,T細胞亞群中CD4+T細胞水平進一步減低(P0.05),其余(包括CD3+、CD8+、CD19+和NK)均無統(tǒng)計學(xué)差異(P0.05)。術(shù)后1月與治療前檢測對比分析,CD3+和CD4+T細胞亞群的絕對和百分數(shù)與治療前相比組間具有統(tǒng)計學(xué)差異(P0.05),但仍低于正常組。細胞因子檢測顯示：脊柱結(jié)核患者治療前IFN-γ蛋白水平均低于健康對照組,差別具有顯著統(tǒng)計學(xué)意義(P0.01)；而IL-4蛋白水平組間比較差別無統(tǒng)計學(xué)意義(P0.05)。手術(shù)前后比較,IFN-γ和IL-4蛋白水平無明顯的變化。手術(shù)后1月患者的IFN-γ有所提高,但仍低于正常水平(P0.05)。 結(jié)論：脊柱結(jié)核患者T淋巴細胞的免疫功能下降,其中以CD4+T淋巴細胞絕對數(shù)和百分數(shù)降低為主；同時,主要由CD4+T淋巴細胞分泌為主的細胞因子IFN-γ的表達也受到明顯的抑制。手術(shù)應(yīng)激可進一步降低機體的免疫力。T細胞亞群和細胞因子IFN-γ和IL-4水平隨著治療時期的不同而變化,可較好的體現(xiàn)免疫力狀態(tài),為個體化治療方案的制定提供重要的參考。
[Abstract]:Objective: to detect the changes of T lymphocyte subsets, cytokines IFN- 緯 and IL-4 in peripheral blood of patients with spinal tuberculosis at different time points during the course of disease, and to explore the changes of immunity in patients with spinal tuberculosis. To provide some basis for the formulation and adjustment of individual treatment of spinal tuberculosis. Materials and methods: single platform flow cytometry was used to detect the absolute number and percentage of T lymphocyte subsets (CD3, CD 4, CD 8, CD 8, CD 19 and NKC) in the peripheral blood of 51 newly treated patients, and compared with the corresponding indexes of the healthy control group. Among them, 36 cases who underwent surgical treatment and completed T cell subsets test within 1-3 days after operation were compared before and after operation, and those who returned on time in 1 month after operation were also tested. The level of T cell subsets was compared with that before treatment. The plasma samples obtained from the mononuclear cells were cryopreserved. The levels of IFN- 緯, IL-4 and protein were detected by flow cytometry, and compared with the corresponding time points. Results: the absolute number and percentage of CD3 T lymphocytes and CD4 T lymphocytes in patients with spinal tuberculosis were lower than those in healthy controls. The absolute numbers and percentages of CD8 T, CD19 and NK cells were not significantly different from those of healthy controls. The levels of CD4 T cells in the T cell subsets were further decreased before and after operation, while the rest (including CD3 CD8 + CD19 and NKK) had no significant difference (P 0.05). The absolute and percentage of CD3 and CD4 T cell subsets were significantly different from those before treatment (P 0.05), but were still lower than that of normal group (P < 0.05). The level of IFN- 緯 protein in patients with spinal tuberculosis before treatment was lower than that in healthy control group, and the difference was statistically significant (P 0.01), but there was no significant difference in IL-4 protein level between the two groups. There were no significant changes in IFN- 緯 and IL-4 protein levels before and after operation. IFN- 緯 was increased in patients at 1 month after operation, but it was still below the normal level (P 0.05). Conclusion: the immune function of T lymphocytes in patients with spinal tuberculosis was decreased, in which the absolute number and percentage of CD4 T lymphocytes were mainly decreased, and the expression of IFN- 緯, which was mainly secreted by CD4 T lymphocytes, was also significantly inhibited. The level of IFN- 緯 and IL-4 could be decreased by operation stress, which could reflect the immune state and provide an important reference for individual treatment.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R529.2

【參考文獻】

相關(guān)期刊論文 前10條

1 陳曉東，，潘家華;骨與關(guān)節(jié)結(jié)核患者T淋巴細胞亞群觀察[J];蚌埠醫(yī)學(xué)院學(xué)報;1995年01期

2 馮群芳;張杰;;結(jié)核病的細胞免疫研究進展[J];華夏醫(yī)學(xué);2006年03期

3 廖智輝;前路一期病灶清除植骨內(nèi)固定治療脊柱結(jié)核[J];醫(yī)學(xué)臨床研究;2005年05期

4 吳玉海;白劍;張俊;李紹龍;劉海東;劉書林;張健飛;楊菁;;化膿性結(jié)核病患者T淋巴細胞亞群分類變化特征[J];中華實用診斷與治療雜志;2010年03期

5 張影;陸堅;邱振綱;張興樹;張明霞;陳心春;;結(jié)核病患者外周血B細胞及其亞群的檢測[J];臨床肺科雜志;2012年06期

6 楊生海;殷宏;劉永生;張杰;;干擾素-γ研究進展[J];生物技術(shù)通報;2010年08期

7 李德憲;張?zhí)焱?譚守勇;肖們;譚耀駒;張賢蘭;;治療期肺結(jié)核患者外周血CD4~+ T細胞變化的臨床意義[J];細胞與分子免疫學(xué)雜志;2010年07期

8 胡大林,莊志雄,何云;RNA干擾與基因沉默的分子機制研究進展[J];中國職業(yè)醫(yī)學(xué);2005年04期

9 李奇鳳;袁俐;;結(jié)核病與Th1/Th2細胞亞群研究進展[J];中國防癆雜志;2007年03期

10 王愛民，周肇平，周明華，ＩＣ．Ｂｒｕｃｅ，余婉華;自體帶血管神經(jīng)移植修復(fù)脊髓損傷的初步研究[J];中華骨科雜志;1995年10期

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