肺结核患者支气管肺泡灌洗液中T细胞亚群的检测

目的探讨肺结核患者支气管肺泡灌洗液（Bronchoalveolar Lavage Fluid,BALF）中T细胞亚群及免疫状态的变化。方法予54例肺结核患者留取痰液并行支气管肺泡灌洗术获得BALF,对痰和BALF结核菌涂片进行抗酸染色镜检,用碱性磷酸酶-抗碱性磷酸酶（APAAP）桥联酶标法测定54例肺结核患者与30例对照组BALF中T淋巴细胞亚群。结果 BALF细菌学检查阳性率51.85%,明显高于痰检24.07%（P〈0.05）;T淋巴细胞亚群,肺结核组较对照组,CD3降低,CD4降低,CD8升高,CD4/CD8降低,其差异在统计学上有意义（P〈0.05）。结论 BALF细菌学检查对肺结核的快速诊断具有重要的临床价值,T淋巴细胞亚群可作为肺结核患者免疫状态的指标,并可指导临床治疗。

Detection of T lymphocyte subsets in bronchoalveolar lavage fluid in patients with pulmonary tuberculosis

Objective To study the changes of T lymphocyte subsets in BALF（Bronchoalveolar Lavage Fluid） and immune status in patients with pulmonary tuberculosis.Methods There were 54 tuberculosis patients collected sputum and underwent bronchial alveolar lavage to get BALF.All samples of BALF and sputum were tested for MTB（Mycobacetium Tuberculosis） by microscope examination using acid fast staining.T lymphocyte subsets were tested by alkaline phosphatase-anti-alkaline phosphatase（APAAP） bridging enzyme linked immunosorbent assay between 54 tuberculosis patients and 30 control group.Results The positive rate of BALF（51.85%） was significantly higher than that of sputum（24.07%）P 〈0.05.CD3,CD4,CD4/ CD8,in tuberculosis patients were significantly lower than those in control group.However,the values of CD8 were significantly higher than those in control group.There was statistically significant difference（P 〈0.05）.Conclusion Acid fast staining for MTB using BALF is of significantly clinical value for rapid diagnosis of pulmonary tuberculosis.T lymphocyte subsets can be used as the index of immune status in patients with pulmonary tuberculosis,and to guide clinical therapy.