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目的探讨结核性脑膜炎患者外周血CD4+、CD8+T淋巴细胞的变化及与脑脊液常规生化指标的相关性。方法利用流式细胞仪检测结核性脑膜炎组(46例)、对照组(18人)外周血CD4+、CD8+T淋巴细胞数值,并与脑膜炎患者的脑脊液常规生化指标进行相关性分析。结果结核性脑膜炎患者外周血CD4+、CD8+T淋巴细胞值与对照组比较明显下降。结核性脑膜炎患者外周血CD4+、CD8+T淋巴细胞与脑脊液常规生化指标无相关性。抗结核治疗8周后,结核性脑膜炎好转组的患者外周血CD4+、CD8+T淋巴细胞值与恶化组比较差异无统计学意义。结论结核性脑膜炎患者的细胞免疫功能低于健康对照组;不能单一通过外周血T淋巴细胞的数值去判断结核性脑膜炎的严重程度以及预测其治疗效果。
Objective To investigate the changes of CD4 +, CD8 + T lymphocytes in peripheral blood of patients with tuberculous meningitis and its correlation with routine biochemical markers in cerebrospinal fluid. Methods Flow cytometry was used to detect the numbers of CD4 + and CD8 + T lymphocytes in peripheral blood of tuberculous meningitis group (46 cases) and control group (18 cases). The correlation was analyzed with routine biochemical indexes of cerebrospinal fluid in patients with meningitis. Results The levels of CD4 + and CD8 + T lymphocytes in peripheral blood of patients with tuberculous meningitis were significantly lower than those in the control group. There was no correlation between CD4 + and CD8 + T lymphocytes in peripheral blood of patients with tuberculous meningitis and routine biochemical indexes of cerebrospinal fluid. After 8 weeks of anti-TB treatment, there was no significant difference in CD4 +, CD8 + T lymphocyte counts between peripheral blood and patients with worsening tuberculous meningitis. Conclusions The cellular immune function of patients with tuberculous meningitis is lower than that of the healthy control group. The value of T lymphocytes in peripheral blood can not be used to judge the severity of tuberculous meningitis and to predict the therapeutic effect.