Meshi Amit, Neudorfer Meira, Fireman Elizabeth
Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.
Sarcoidosis Vasc Diffuse Lung Dis. 2012 Mar;29(1):34-40.
The aim of this study was to establish a correlation between the diagnosis of ocular sarcoidosis and the presence of an elevated CD4/CD8 ratio in the induced sputum(IS) of patients with uveitis and no other systemic symptoms.
This retrospective chart review study included all newly diagnosed uveitis patients treated between 1998-2006. IS examinations and determination of angiotensin-converting enzyme (ACE) levels were carried out. A CD4/CD8 ratio > 2.5 and an ACE level > 145 Cd/ml/min were considered abnormal. The etiology of uveitis was retrieved from the medical records.
Twenty males and 26 females (mean age 47 +/- 16.1 years) were enrolled. The CD4/CD8 ratio was elevated in 26 (56.5%) patients, and five (10.9%) were diagnosed as having sarcoidosis by the end of follow-up. The sensitivity and specificity of the T lymphocytes CD4/CD8 ratio in diagnosing sarcoidosis were 100% and 48.8%, respectively. CD4/CD8 ratios were not significantly different between the sarcoid and non-sarcoid groups (p > 0.05), but the former tended to have higher levels (p = 0.0991). The mean ACE level of the sarcoid patients was significantly higher than that of the non-sarcoid patients (p < 0.001).
CD4/CD8 lymphocytes ratios obtained by IS were sensitive in uveitis patients with concomitant sarcoidosis, suggesting that analysis of T cells subsets in IS may rule out an etiology of sarcoidosis in newly diagnosed uveitis patients.
本研究旨在确定葡萄膜炎且无其他全身症状患者的眼部结节病诊断与诱导痰(IS)中CD4/CD8比值升高之间的相关性。
这项回顾性图表审查研究纳入了1998年至2006年间所有新诊断的葡萄膜炎患者。进行了IS检查和血管紧张素转换酶(ACE)水平测定。CD4/CD8比值>2.5和ACE水平>145 Cd/ml/min被视为异常。从病历中检索葡萄膜炎的病因。
共纳入20名男性和26名女性(平均年龄47±16.1岁)。26名(56.5%)患者的CD4/CD8比值升高,随访结束时5名(10.9%)被诊断为结节病。T淋巴细胞CD4/CD8比值诊断结节病的敏感性和特异性分别为100%和48.8%。结节病组和非结节病组的CD4/CD8比值无显著差异(p>0.05),但前者往往有更高的水平(p=0.0991)。结节病患者的平均ACE水平显著高于非结节病患者(p<0.001)。
IS获得的CD4/CD8淋巴细胞比值对合并结节病的葡萄膜炎患者敏感,提示分析IS中的T细胞亚群可能排除新诊断葡萄膜炎患者的结节病病因。