【摘要】 目的研究不同时期结节病患者外周血淋巴细胞亚群Th17细胞的表达变化,并探讨其临床意义。方法选取结节病患者38例,其中初诊并伴有咳嗽、乏力、消瘦、发热等明显临床症状的活动期结节病患者18例,复诊的稳定期结节病患者20例。另选取15例健康志愿者为对照组。流式细胞术检测所有入选者外周血Th17细胞表达,紫外分光光度法检测所有结节病患者血管紧张素转化酶(SACE)水平。所有初诊结节病患者行支气管肺泡灌洗液细胞分类及CD4+/CD8+比例检查。结果活动期结节病患者外周血Th17/CD3+T细胞百分比较稳定期结节病患者及健康对照组明显增高[(1.59±0.44)%比(0.56±0.32)%和(0.49±0.23)%,P均<0.05],而稳定期结节病患者外周血Th17/CD3+T细胞百分比与健康对照组无明显差异(P>0.05)。活动期结节病患者SACE水平较稳定期结节病患者SACE水平明显增高[(56.6±14.6)IU/L比(35.8±18.3)IU/L,P<0.05],结节病患者外周血Th17细胞表达与SACE水平无明显相关性(P>0.05);活动期结节病外周血Th17细胞表达与BALF中淋巴细胞百分比无明显相关性(P>0.05),但与CD4+/CD8+呈明显正相关(r=0.63,P<0.05)。结论活动期结节病患者外周血Th17细胞表达增高,结节病患者外周血Th17细胞表达增高可能与结节病的病情活动有关。更多还原

【Abstract】 Objective To investigate the expression of Th17 cells in peripheral blood of patients with sarcoidosis at different stage.Methods Flow cytometry was used to detect the Th17 cells in peripheral blood of 38 patients with sarcoidosis,including 18 cases of newly diagnosed active patients with obvious symptoms such as cough,fever,fatigue and weight loss,and 20 stable cases who were followed up regularly.15 cases of healthy volunteers were enrolled as control.Serum angiotensin-converting enzyme(SACE) of the patients with sarcoidosis was detected by ultraviolet spectrophotometry.The cell classification and CD4+/CD8+ T in the BALF of the newly diagnosed active patients were calculated.Results The expression of Th17 cells in peripheral blood in the patients with active sarcoidosis were higher than that in the sable patients and the controls [(1.59±0.44)% vs.(0.56±0.32)% and(0.49±0.23)%,all P<0.05].Th17 cells in peripheral blood in the patients with stable sarcoidosis and the controls were not different significantly(P>0.05).The levels of SACE in the patients with active sarcoidosis were higher than that in the patients with stable sarcoidosis [(56.6±14.6)IU/L vs.(35.8±18.3)IU/L,P<0.05).There was not significant correlation between the Th17 cells in peripheral blood and SACE in the patients with sarcoidosis(P>0.05).In the patients with active sarcoidosis,the Th17 cells in peripheral blood were not significantly correlated with lymphocyte percentages in BALF(P>0.05),but significantly correlated with CD4+/CD8+ in BALF(r=0.63,P<0.05).Conclusion In patients with active sarcoidosis,the increased expression of Th17 cells in peripheral blood may correlate with the activity of sarcoidosis.更多还原