Abstract: Objective To study the distributive characteristics of CD4⁺T helper subtypeⅠandⅡ(Th1/Th2) and Th1-type cytokine(IFN-γ) and Th2-type cytokine(IL-4) in the peripheral blood and the cerebrospinal fluid in patients with tuberculous meningitis,and to gain insight into the poss-ible role of the local and the systemic Th1/Th2 cell-mediated immune response in the pathogenesis of tuberculous meningitis.Methods The ratio of Th1/Th2 cells in the peripheral blood and the cerebrospinal fluid from patients with tuberculous meningitis at the begining and at the three months of chemotherapy was determined by Flow Cytometry,and the concentrations of IFN-γ,IL-4 in the serum and the cerebrospinal fluid of patients with tuberculous meningitis were measured with cytometric bead array(CBA).30 health controls were determined the ratio of Th1/Th2 cells and the concentrations of cytokine in the sera.Results(1) The ratio of Th1/Th2 cells in peripheral blood and the concentrations of IFN-γ,IL-4 in the sera were 3.8%±0.9%,2.03%±1.51%,29.05 ng/L,55.05 ng/L respectively in group tuberculous meningitis at the begining of chemotherapy,4.0%±0.8%,1.6%±1.1%,30.60 ng/L,52.70 ng/L respectively in group tuberculous meningitis at the three months of chemotherapy,6.3%±2.6%,1.7%±0.6%,65.95 ng/L,50.30 ng/L in group healthy.For the ratio of Th1 and the concentrations of IFN-γ in the blood of group tuberculous meningitis were lower than those in group healthy control(P<0.05).There were no statistical differences between the beginning and three months after chemotherapy in group tuberculous meningitis(P>0.05).(2) The ratio of Th1 cells in the cerebrospinal fluid from 25 patients with tuberculous meningitis at the begining and the three months of chemotherapy were 8.4%±4.6%,7.1%±4.4%,respectively.(3) The concentrations of IFN-γ in the cerebrospinal fluid from 30 patients with tuberculous meningitis at the begining and the three months of chemotherapy were 176.45 ng/L、75.50 ng/L,respectively.Conclusions The level of Th1 cells in the peripheral blood from group tuberculous meningitis was lower than that in group healthy control.Th1 response in the cerebrospinal fluid from the patients with tuberculous meningitis at the begining of chemotherapy was higher than that at the three months of chemotherapy.

Key words: tuberculous, meninges/pathophysiology, tuberculous, mening/immunology, Th1 type cell, Th2 type cell