摘要：
目的 探讨淋巴细胞与细胞因子在喉结核患者体内表达的临床意义.方法 筛选96例喉结核患者作为研究对象,其中浸润型42例,溃疡型31例,肿块型23例,另选取同期体检健康人员50例,作为健康对照组,抽取所有研究对象清晨空腹外周静脉血进行T淋巴细胞亚群及细胞因子检测,并对比各组检测结果.结果 浸润型喉结核CD3+为(63.10 ±5.33)％、CD4+为(40.32±5.06)％、CD8+为(24.41±4.59)％,与对照组比较CD3+、CD4+指标显著降低,CD8+指标明显上升,差异均有统计学意义(t=1.922、1.758、1.710,均P＜0.05),并且溃疡型与肿块型、浸润型结果比较差异均有统计学意义(均P＜0.05).而在喉结核病理类型分析中,肿块型CD3+、CD4+T淋巴细胞指标降低及CD8+指标明显升高;所有喉结核患者IL-4、IL-10及TNF-α明显较对照组升高,而IFN-γ明显降低,并且以肿块型变化最为显著,差异均有统计学意义(均P＜0.05).结论 采用淋巴细胞及细胞因子检测可提高喉结核患者的临床确诊率,并且不同病理分型的喉结核患者有不同的检测结果,可用于喉结核病情及病理分型的初步评估,对患者治疗方式的选择有指导价值,具有临床深入研究及推广应用的价值.%Objective To investigate the clinical significance of the expression of lymphocytes and cytokines in patients with laryngeal tuberculosis.Methods 96 cases of laryngeal tuberculosis were selected as the research objects.Of which 42 cases of infiltrating type,31 cases of ulcer type,mass type in 23 cases,the other 50 cases of healthy persons were selected as the healthy control group,all the research objects,extracting the morning fasting venous peripheral blood for detection of T lymphocyte subsets and cytokines were detected,and the results were compared.Results Invasive laryngeal tuberculosis CD3+ index (63.10 ± 5.33) ％ (t =1.922),CD4+ (40.32 ± 5.06) ％ (t =1.758),CD8+ (24.41 ± 4.59) ％ (t =1.710),compared with the control group,CD4+,CD3+ index significantly reduced,CD8+ index increased significantly,the differences had statistical significance (t =1.922,1.758,1.710,all P ＜ 0.05),and the ulcer type and mass type results compared with invasive had significant difference(all P ＜0.05).In the analysis of laryngeal tuberculosis pathological types,reduced the mass type CD3+,CD4+ T index and CD8+ index of lymphocyte increased obviously the most significant;all laryngeal tuberculosis in patients with IL-4,IL-10 and TNF-alpha significantly increased compared with the control group,while the IFN-gamma was significantly reduced,and the mass in the type of change was the most significant,the differences had statistical significance(all P ＜ 0.05).Conclusion The use of lymphocytes and cytokines detection can improve the laryngeal tuberculosis patients with the clinical diagnosis rate,with the detection results of different degree and different pathological types of laryngeal tuberculosis patients,can be used for preliminary assessment of laryngeal tuberculosis disease and pathological type,the choice of treatment modality for patients with guidance value,with in-depth clinical study and promotion application of value.
