Changes of CD cells in peripheral blood of tuberculous meningitis patients with negative HIV antibody before and after treatment

doi:10.19982/j.issn.1000-6621.20210349

Abstract

Abstract:

Objective: To analyze the changes and clinical significance of CD cells in peripheral blood of tuberculous meningitis (TBM) patients with negative HIV antibody before and after treatment. Methods: A prospective study was conducted in 102 TBM patients diagnosed in the Eighth Affiliated Hospital of Xinjiang Medical University from March 2016 to February 2020.All the cases met the inclusion criteria and were divided them into 3 clinical phases, 22 in phase Ⅰ, 37 in phase Ⅱ, and 43 in phase Ⅲ. The counts of CD3 ⁺, CD4⁺ and CD8⁺ T cells, and the ratio of CD4⁺/CD8⁺ T cells in peripheral blood of these cases were measured before and 2 weeks after anti-tuberculosis treatment. The changes of CD cells in peripheral blood before and after treatment, and their correlation with TBM clinical stages and therapeutic prognosis were analyzed. Results: Of these cases, the CD3⁺, CD4⁺ T cell counts and CD4⁺/CD8⁺ 2 weeks after anti-tuberculosis treatment were significantly higher than those before treatment ((808.27±183.25)×10⁶/μl vs. (631.38±150.14)×10⁶/μl, t=7.541,P=0.000; (413.09±134.53)×10⁶/μl vs. (366.78±98.03)×10⁶/μl, t=2.809,P=0.005; and 1.23±0.29 vs. 0.99±0.23, t=6.548,P=0.000; respectively). Two weeks after anti-tuberculosis treatment, the CD3⁺, CD4⁺ T cell counts and CD4⁺/CD8⁺ of patients in stage Ⅲ ((613.23±140.29)×10 ⁶/μl, (342.53±98.36)×10⁶/μl and 0.95±0.18, respectively) were significantly lower than those in stage Ⅱ ((753.33±153.47)×10⁶/μl, (399.57±112.26)×10⁶/μl and 1.22±0.21, respectively)and stage Ⅰ ((989.23±194.35)×10⁶/μl,(501.11±139.25)×10⁶/μl and 1.42±0.31, respectively)(F=40.875,13.372 and 32.151, respectively; all P=0.000). The CD3⁺, CD4⁺ T cell counts and CD4⁺/CD8⁺ of improved patients were significantly higher than those of patients with progressive forms of the disease ((941.25±204.17)×10⁶/μl vs. (683.43±155.76)×10⁶/μl, t=4.206, P=0.000; (487.35±134.25)×10⁶/μl vs. (389.64±120.38)×10⁶/μl, t=2.394, P=0.018; 1.36±0.31 vs. 1.02±0.19, t=3.698, P=0.000; respectively). Conclusion: Two weeks after anti-tuberculosis treatment, the immune function of TBM patients was significantly improved, and the improvement of immune function in improved patients was better than those with worse condition. For TBM patients, the higher the clinical stage, the more severe the impairment of immune function, and the higher the need to adjust the therapeutic regimen.

Key words: Tuberculosis,meningeal, Lymphocyte subsets, Causality, Evaluation studies

CLC Number:

R529.3

WANG Xin, Maierdan·Abulai, LIN Yi-hong, ZHANG Wen-tao. Changes of CD cells in peripheral blood of tuberculous meningitis patients with negative HIV antibody before and after treatment[J]. Chinese Journal of Antituberculosis, 2022, 44(1): 78-82. doi: 10.19982/j.issn.1000-6621.20210349

Figures/Tables 3

CD细胞	Ⅰ期(22例)	Ⅱ期(37例)	Ⅲ期(43例)	F值	P值
CD3⁺T细胞计数(×10⁶个/μl, $x ¯$ ±s)
治疗前	793.26±156.22	657.45±149.65	548.22±132.16	18.113	0.000
治疗后	989.23±194.35	753.33±153.47	613.23±140.29	40.875	0.000
t值	4.095	4.413	2.051
P值	0.000	0.000	0.043
CD4⁺ T细胞计数(×10⁶个/μl, $x ¯$ ±s)
治疗前	406.81±100.14	355.46±94.53	295.52±93.34	7.716	0.000
治疗后	501.11±139.25	399.57±102.26	342.53±98.36	13.372	0.000
t值	2.578	2.036	2.108
P值	0.013	0.044	0.038
CD8⁺ T细胞计数(×10⁶个/μl, $x ¯$ ±s)
治疗前	334.53±92.24	359.72±94.72	380.33±98.35	1.052	0.354
治疗后	322.23±90.47	333.23±91.12	362.12±94.11	1.583	0.211
t值	0.446	1.321	0.813
P值	0.657	0.189	0.418
CD细胞	Ⅰ期(22例)	Ⅱ期(37例)	Ⅲ期(43例)	F值	P值
CD4⁺/CD8⁺ T细胞比值( $x ¯$ ±s)
治疗前	1.14±0.25	0.97±0.20	0.78±0.15	24.282	0.000
治疗后	1.42±0.31	1.22±0.21	0.95±0.18	32.151	0.000
t值	3.297	5.653	4.413
P值	0.002	0.000	0.000

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