Başoğlu Ozen Kaçmaz, Atasever Alev, Gündüz Telli Canan, Ozol Duygu, Aşçi Gülay, Ardeniz Omür, Güzelant Asuman, Bacakoğlu Feza, Sayiner Abdullah
Department of Chest Diseases, Faculty of Medicine, Ege University, Izmir, Turkey.
Tuberk Toraks. 2006;54(1):5-10.
As anergy is common in patients with chronic renal failure (CRF), the use of tuberculin skin test (TST) is controversial. Therefore, determination of the factors that affect the TST reactivity would increase the diagnostic value of the test. The aim of the present study was to investigate the factors affecting TST reactivity and evaluate the relationship between T-lymphocyte subsets and TST reactivity. We thus examined 44 patients (mean age 46.6 +/- 15.6 years, 25 males, duration of CRF 5.6 +/- 5.2 years), performed TST (an induration with a diameter of 5 mm or more was considered as positive) and measured Tlymphocyte subsets and biochemical parameters. Twenty-three patients were on hemodialysis, six were on peritoneal dialysis, seven were transplant recipients, and eight were on medical treatment. Eleven patients (25%) had immunosuppressive treatment. Eleven patients (25%) had two, 29 patients (66%) had one, and four patients (9%) had no BCG scars. Five patients (11%) had low body mass index (BMI). T-lymphocyte subsets were as follows: CD4= 40.7 +/- 7.6%, CD8= 32 +/- 8.9%, CD4/CD8= 1.7 +/- 2.5%, CD3= 71.4 +/- 9.4%, CD19= 6.3 +/- 5.1%, NK= 9.7 +/- 5.9. Twenty-two patients had positive TST reactivity. No relation was found between TST reactivity and age, gender, co-morbidity, BCG vaccination, BMI, immunosuppressive therapy, duration and treatment of CRF. Similarly, TST reactivity was not related to the biochemical parameters and Tlymphocyte subsets. These data provide that tuberculin reactivity does not seem to be associated with T-lymphocyte dysfunction and clinical features in patients with chronic renal failure.
由于无反应性在慢性肾衰竭（CRF）患者中很常见，结核菌素皮肤试验（TST）的应用存在争议。因此，确定影响TST反应性的因素将提高该试验的诊断价值。本研究的目的是调查影响TST反应性的因素，并评估T淋巴细胞亚群与TST反应性之间的关系。我们因此检查了44例患者（平均年龄46.6±15.6岁，男性25例，CRF病程5.6±5.2年），进行了TST（硬结直径5mm或更大被视为阳性）并测量了T淋巴细胞亚群和生化参数。23例患者接受血液透析，6例接受腹膜透析，7例为移植受者，8例接受药物治疗。11例患者（25%）接受免疫抑制治疗。11例患者（25%）有两处卡介苗瘢痕，29例患者（66%）有一处，4例患者（9%）无卡介苗瘢痕。5例患者（11%）体重指数（BMI）较低。T淋巴细胞亚群如下：CD4 = 40.7±7.6%，CD8 = 32±8.9%，CD4/CD8 = 1.7±2.5%，CD3 = 71.4±9.4%，CD19 = 6.3±5.1%，NK = 9.7±5.9。22例患者TST反应性为阳性。未发现TST反应性与年龄、性别、合并症、卡介苗接种、BMI、免疫抑制治疗、CRF病程及治疗之间存在关联。同样，TST反应性与生化参数和T淋巴细胞亚群无关。这些数据表明，结核菌素反应性似乎与慢性肾衰竭患者的T淋巴细胞功能障碍及临床特征无关。
