【摘要】 目的观察不同年龄活动性肺结核患者治疗过程的临床表现以及T细胞亚群的动态改变,探讨老年肺结核患者T细胞免疫状态与疾病恢复的关系。方法选择初治菌阳肺结核患者80例,根据年龄分为A组（年龄<60岁,40例）、B组（年龄≥60岁,40例）。A、B组均完成2HRZE/4HR抗结核治疗。分别于明确诊断后治疗前（T0期）、治疗1个月（T1期）、治疗6个月（T6期）3个不同时点,观察患者临床症状、痰涂片转阴情况、胸部X线及T细胞亚群变化,比较2组在各治疗阶段免疫状态的动态变化。结果 T1期时A组临床疗效、痰抗酸染色转阴率及影像学好转率均高于B组,而T₆期2组差异无统计学意义。T细胞:组间、时点间、组间·时点间交互作用差异均有统计学意义（P<0.05）。Th细胞:组间、时点间差异有统计学意义（P<0.05）,组间·时点间交互作用差异无统计学意义（P>0.05）。Ts细胞:组间差异有统计学意义（P<0.05）,时点间、组间·时点间交互作用差异无统计学意义（P>0.05）。Th/Ts比值:组间差异有统计学意义（P<0.05）,时点间、组间·时点间交互作用差异无统计学意义（P>0.05）。结论老年继发性肺结核患者T细胞免疫功能较中青年患者低,且直接影响老年肺结核患者治疗效果以及治愈时间。更多还原

【Abstract】 Objective Through the dynamic observation of clinical manifestation and T cell subsets in patients with active pulmonary tuberculosis in differet ages and in different stages of the treatment,to investigate the relationship between the disease variety and T cell-mediated immunity in elderly patients.Methods Eighty patients with secondary pulmonary tuberculosis were divided into group A(younger than 60 years old,40cases)and group B(older than 60 years old,40cases).All patients were received 2HRZE/4HR anti-tuberculosis treatment.In three different time points[before the treatmen(T0)/1months after the treatment(T1)/6months after the treatment(T6)],the changes of the chlinical symptoms/sputum smeat/the chest X-ray images and T lymphocyte subpopulations of venous blood were analyzed.The dynamic changes ofimmune status in 2groups were compared and analyzed.Results In the perid of T1,the clinical manifestations,sptutum smear negative conversion rate and image performanses of group A were better than those of group B.In the period of T6,the difference of effective rates between two groups had no statistical significance.There were significant differences in the interaction between the groups,the time point and the time between groups for T cells(P<0.05).For Th cells,The difference between groups and time points was statistically significant(P<0.05),but there was no significant difference in the interaction between group and time(P>0.05).For Ts cells,there were statistically significant differences between the groups(P<0.05),but there was no significant difference in the interaction between time and group time between the two groups(P>0.05).For Th/Ts ratio,there were statistically significant differences between the groups(P<0.05),but there was no significant difference in the interaction between time and group time between the two groups(P>0.05).Conclusion T immune function in elderly patients with secondary pulmonary tuberculosis was lower than that in young patients,and it has a direct impact on the treatment of elderly patients with pulmonary tuberculosis.更多还原