The changes in peripheral blood of T lymphocyte subsets in patients with pulmonary tuberculosis and extra-pulmonary tuberculosis and its clinical significance

doi:10.3969/j.issn.1000-6621.2019.10.005

Abstract

Abstract:

Objective To investigate the changes of CD3 ⁺, CD4 ⁺, and CD8 ⁺ T lymphocyte subsets as well as CD4 ⁺/CD8 ⁺ ratio in peripheral blood and its clinical significance in patients with extra-pulmonary tuberculosis (EPTB).Methods A total of 147 patients, including 63 cases of pulmonary tuberculosis (PTB), 60 cases of PTB combined with EPTB (PTB&EPTB) and 24 cases of EPTB, who hospitalized in the tuberculosis area in the Public Health Clinical Center of Chengdu from October 2017 to January 2019 were enrolled in this study. The absolute counts of CD3 ⁺, CD4 ⁺ and CD8 ⁺ T lymphocyte subsets in peripheral blood and the ratio of CD4 ⁺/CD8 ⁺ were detected by flow cytometry and four-color lymphocyte subset detection kit. Then the differences of CD3 ⁺, CD4 ⁺ and CD8 ⁺ counts combined with the ratio of CD4 ⁺/CD8 ⁺ between groups were analyzed.Results CD3 ⁺ and CD4 ⁺ counts in the peripheral blood of patients with PTB&EPTB were 596.000 (377.500, 823.250) cells/μl and 347.500 (214.000, 479.250) cells/μl, respectively, which were significantly lower than those in patients with PTB (698.000 (572.000, 904.000) cells/μl and 409.000 (311.000, 545.000) cells/μl) (Z=-2.507, P=0.012; and Z=-2.431, P=0.015, respectively). The CD8 ⁺ count and the ratio of CD4 ⁺/CD8 ⁺ in patients with PTB&EPTB were 195.500 (137.250, 278.750) cells/μl and 1.670 (1.258, 2.273), respectively, were decreased compared with patients with PTB (244.000 (154.000, 317.000) cells/μl and 1.770 (1.290, 2.350)), while without statistically significant difference (Z=-1.892, P=0.058; Z=-0.546, P=0.585, respectively). In addition, CD3 ⁺ and CD4 ⁺counts in the peripheral blood of patients with EPTB were 551.500 (283.750, 949.000) cells/μl and 295.500 (134.250, 461.750) cells/μl, were significantly lower compared to patients with PTB (698.000 (572.000, 904.000) cells/μl and 409.000 (311.000, 545.000) cells/μl) (Z=-2.089, P=0.037; and Z=-2.460, P=0.014, respectively). However, the CD8 ⁺ counts and the ratio of CD4 ⁺/CD8 ⁺ presented no significant difference (Z=-1.315, P=0.188; and Z=-1.429, P=0.153, respectively) between patients with EPTB (185.000 (92.000, 366.250) cells/μl and 1.455 (1.018, 2.128)) and patients with PTB (244.000 (154.000, 317.000) cells/μl and 1.770 (1.290, 2.350)).Conclusion With the gradual decrease of CD3 ⁺ and CD4 ⁺ counts in the peripheral blood of patients with PTB, Mycobacterium tuberculosis may more easily disseminate to the outside of the lung, while the roles of CD8 ⁺ counts and the ratio of CD4 ⁺/CD8 ⁺ in the mechanism of EPTB still need to be further explored.

Key words: Tuberculosis, pulmonary, T-lymphocyte subsets, Cell count, CD4-CD8 ratio, Data interpretation, statistical, Tuberculosis, extra-pulmonary

Wei HE,Qing CHEN,Tao HUANG,Xiao-qiu HUANG,Gui-hui WU. The changes in peripheral blood of T lymphocyte subsets in patients with pulmonary tuberculosis and extra-pulmonary tuberculosis and its clinical significance[J]. Chinese Journal of Antituberculosis, 2019, 41(10): 1090-1095. doi: 10.3969/j.issn.1000-6621.2019.10.005

Figures/Tables 3

References 25

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临床参数	肺结核 (63例)	肺结核并发肺外结核(60例)	肺外结核 (24例)	统计检验值	P值
平均年龄[岁,M(Q₁,Q₃)]	37.00(22.00,59.00)	33.50(22.00,47.00)	36.50(22.50,53.00)	H=0.790	0.674
性别[例数,构成比(%)]				χ²=0.604	0.739
男	39(61.9)	33(55.0)	14(58.3)
女	24(38.1)	27(45.0)	10(41.7)

组别	例数	CD3⁺ [个/μl,M(Q₁,Q₃)]	CD4⁺ [个/μl,M(Q₁,Q₃)]	CD8⁺ [个/μl,M(Q₁,Q₃)]	CD4⁺/CD8⁺ [M(Q₁,Q₃)]
肺结核	63	698.000 (572.000,904.000)	409.000 (311.000,545.000)	244.000 (154.000,317.000)	1.770 (1.290,2.350)
肺结核并发肺外结核	60	596.000 (377.500,823.250)	347.500 (214.000,479.250)	195.500 (137.250,278.750)	1.670 (1.258,2.273)
肺外结核	24	551.500 (283.750,949.000)	295.500 (134.250,461.750)	185.000 (92.000,366.250)	1.455 (1.018,2.128)
H值		8.900	8.989	4.506	2.132
P值		0.012	0.011	0.105	0.344