林医生：白细胞降低性肺炎患者CD4+CD25+调节性T细胞的表达及临床意义.doc

白细胞降低性肺炎患者CD4+CD25+调节性T细胞的表达与临床意义 林燕梅 （东莞市大朗医院内一科，广东 东莞，523770） 林燕梅，女，1972年出生，呼吸内科硕士，副主任医师。通讯方式：广东省东莞市大朗镇金朗中路85号【摘要】背景：白细胞降低往往容易导致特殊病原体肺炎的漏诊及误诊，且研究表明该类肺炎与细胞免疫学的异常密切相关。CD4+CD25+ T细胞(Treg)是一种具有抑制性功能的调节性T细胞，在某些类型的肺炎患者的表达升高，但白细胞降低性肺炎患者的Treg表达如何，其临床意义何在？目前尚缺少相关研究。目的：探索Treg在白细胞降低性肺炎发病机制的作用。方法：收集白细胞降低的肺炎患者40例，在连续进行痰培养的3天内采集外周血，采用流式细胞术检测外周血Treg数量，并且将该细胞的数量与病原体的滴度进行相关性分析；另外收集40例志愿者作为对照组。结果：与对照组比较，肺炎组患者的Treg含量明显降低(P0.05)；从自身变化看，第1天的CD8+CD28-含量最低，第2天次之，第3天显著高于前两天(P0.05)。20例患者的病原体依次为：支原体、衣原体、上呼吸道病毒；相关性分析显示Treg数量与支原体感染现在显著相关性(r=-0.783, P0.05)。结论：Treg数量降低在白细胞降低性肺炎发病机制起到重要作用，其含量有助于支原体肺炎的早期诊断。 关键词：肺炎；白细胞降低；CD4+CD25+ T细胞；发病机制 Role of CD4+CD25+ regulatory T cells (Treg) in the pathogenesis for the pneumonia patients with leucopenia LIN Yan-mei. (Internal Medicine Department of Dalang Hospital, Dongguan 523770, China) Abstract: Background: The blood cells reduce often missed diagnosis and misdiagnosis easily lead to special pathogen pneumonia, and studies have shown that this type of pneumonia and cellular immunological abnormalities are closely related. CD4 + CD25 + T cells (Treg) is one kind has the inhibitory function of regulatory T cells, in certain types of pneumonia in patients with higher expression, but white blood cells reduce pneumonia patients express how Treg and its clinical significance? It is the lack of related research. Objective: To explore the Treg in white blood cells reduce the effect to the pathogenesis of pneumonia. Methods: 40 patients with collection of white blood cells reduce pneumonia, sputum culture in continuous 3 days to collect peripheral blood, using flow cytometry test peripheral blood Treg number, and that the number of cells and pathogens of drop degree correlation analysis; In addition to collect 40 volunteers as control group. Results: Compared with control group, the content of Treg in patients with pneumonia group was obviously decreased (P 0.05); From their own change, 1 day of CD4 + CD25 + most, 2 days, 3 days significantly higher than th