文章摘要
朱由瑾,周向昭,吴远慧,等.早期潜伏梅毒病人外周血 T淋巴细胞亚群、自然杀伤细胞的变化及意义[J].安徽医药,2023,27(11):2140-2144.
早期潜伏梅毒病人外周血 T淋巴细胞亚群、自然杀伤细胞的变化及意义
Changes and significance of T lymphocyte subsets and NK cells in peripheral blood of patients with early latent syphilis
  
DOI:10.3969/j.issn.1009-6469.2023.11.005
中文关键词: 梅毒,潜伏  T淋巴细胞亚群  自然杀伤细胞  梅毒滴度
英文关键词: Syphilis,latent  T lymphocyte subsets  Natural killer cells  Syphilis titer
基金项目:河北省政府资助临床医学优秀人才培养项目(冀财预付[ 2020]004号)
作者单位E-mail
朱由瑾 河北北方学院附属第一医院皮肤科河北张家口 075000  
周向昭 河北北方学院附属第一医院皮肤科河北张家口 075000 zxiangz@126.com 
吴远慧 河北北方学院附属第一医院皮肤科河北张家口 075000  
温杰 河北北方学院附属第一医院皮肤科河北张家口 075000  
高晓莉 河北北方学院附属第一医院皮肤科河北张家口 075000  
冯冬梅 河北北方学院附属第一医院皮肤科河北张家口 075000  
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中文摘要:
      目的探讨早期潜伏梅毒病人外周血 T淋巴细胞亚群、自然杀伤细胞( NK)的变化及意义。方法选取 2015年 3月至 2021年 3月河北北方学院附属第一医院诊治的早期潜伏梅毒病人 135例为观察组,另选取同期健康体检者 103例为对照组,均采用流式细胞仪检测外周血 T淋巴细胞亚群( CD3+CD4+CD8+CD4+/CD8+)、 NK细胞水平并进行对比。另根据快速血浆反应素环状卡片试验(RPR)初始滴度将观察组病人分为R、PR初始、滴度、≤1∶8组与 >1∶8组,对比 RPR初始滴度 ≤1∶8组与 >1∶8组外周血 T淋巴细胞亚群、 NK细胞检测结果,并采用 Spearman秩相关性分析法分析外周血 T淋巴细胞亚群、 NK细胞与 RPR初始滴度的相关性。结果观察组外周血 CD3+CD8+绝对计数及所占比例[( 67.79±10.76)%比( 64.85±12.95)%、(29.51±5.92)%比(28.09±5.61)%]与对照组比较均差异计学意义( P>0.05)外周血 CD4+绝对计数及所占比例[( 37.36±7.26)%比( 29.73± 无统、5.84)%]、 CD4+/CD8+所占比例( 1.27±0.25比 1.06±0.21)均高于组( P<0.05),NK细胞绝对计数及所占比例[( 16.59±3.29)%比( 17.46±3.34)%]低于对照组( P<0.05); RPR初始滴度 ≤1∶8组外周血 CD3+CD4+、CD8+绝对计数及所占比例均低于 RPR初始滴度 >1∶8组( P<0.05),且 CD4+/CD8+所占比例低于 RPR初始滴度 >1∶8组( P<0.0、5)NK细胞绝对计数及所占比例均高于 RPR初始滴度 >1∶8组( P<0.05);经 Spearman秩相关性分析显示,早期潜伏梅毒病人外周血,CD3+、CD4+、CD8+绝对计数与百分比均与 RPR初始滴度呈正相关(P<0.05)CD4+/CD8+比值与 RPR初始滴度呈正相关( P<0.05),NK细胞绝对计数、百分比均所占比例均与 RPR初始滴度呈负相关( P<0.05),。结论早期潜伏梅毒病人外周血 CD4+、CD4+/CD8+水平较健康人群均呈现一定程度的上升, NK细胞水平降低,而 CD3+、CD8+细胞水平无明显改变,且外周血 CD3+、CD4+、CD8+、CD4+/CD8+、NK细胞水平均与早期潜伏梅毒病人 RPR初始滴度存在一定的相关性,外周血 T淋巴细胞亚群、 NK细胞的变化可能参与了早期潜伏梅毒的发病过程。
英文摘要:
      Objective To investigate the changes and significance of peripheral blood T lymphocyte subsets and natural killer cells(NK) in patients with early latent syphilis.Methods A total of 135 patients with early latent syphilis diagnosed and treated in the FirstAffiliated Hospital of Hebei North University from March 2015 to March 2021 were selected as observation group, and 103 healthy people at the same period were selected as the control group, and the levels of the peripheral blood T lymphocyte subsets (CD3+, CD4+,CD8+, CD4+/CD8+) and NK cells of them were detected by flow cytometry and compared. According to the initial titer of rapid plasma reagin ring card test (RPR), the patients in the observation group were divided into the RPR initial titer ≤ 1∶8 group and the RPR initial titer > 1∶8 group, and the detection results of peripheral blood T lymphocyte subsets and NK cells were compared between the RPR initial titer ≤ 1∶8 group and the RPR initial titer > 1∶8 group, and the correlation between peripheral blood T lymphocyte subsets, NKcells and RPR initial titer were analyzed by Spearman rank correlation analysis method.Results There was no significant difference in the absolute count and proportion [(67.79±10.76) % vs. (64.85±12.95) % , (29.51±5.92) % vs. (28.09±5.61) %] of CD3+ and CD8+ cells in the peripheral blood between the observation group and the control group (P>0.05), but the absolute count and proportion [(37.36±7.26) % vs. (29.73±5.84) %] of CD4+and the proportion of CD4+/CD8+[(1.27±0.25) vs. (1.06±0.21)] in the peripheral blood of the observation group were higher than those of the control group (P<0.05), and the absolute count and proportion [(16.59±3.29) % vs. (17.46±3.34) %] of NK cell in the peripheral blood of the observation group were higher than those of the control group (P<0.05). The absolute count and proportions of CD3+, CD4+, CD8+ in the peripheral blood of the RPR initial titer ≤1∶8 group were lower than those of RPR initial titer >1∶8 group (P<0.05), and the proportion of CD4+/CD8+ in the peripheral blood of the RPR initial titer ≤ 1∶8 group was lower than that of RPR initial titer >1∶8 group (P<0.05), but the absolute count and proportion of NK cells were higher than those of RPR initial titer >1∶8 group (P<0.05). Spearman rank correlation analysis showed that the absolute count and proportions of CD3+,CD4+, CD8+in peripheral blood of patients with early latent syphilis were positively correlated with the initial RPR titer (P<0.05), and the ratio of CD4+/CD8+ in peripheral blood of patients with early latent syphilis was positively correlated with the initial RPR titer (P< 0.05), while the absolute count and proportion of NK cells was negatively correlated with the initial RPR titer (P<0.05).Conclusion The levels of CD4+, CD4+/CD8+ in peripheral blood of patients with early latent syphilis are higher than those of healthy people, and thelevel of NK cell is lower, but the levels of CD3+ and CD8+ cells have no significant change, and the levels of CD3+, CD4+, CD8+, CD4+/CD8+and NK cells in peripheral blood are correlated with the initial titer of RPR of early latent syphilis patients, and the changes of Tlymphocyte subsets and NK cells in peripheral blood may be involved in the pathogenesis of early latent syphilis.
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