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分析 II 期结节病患者淋巴结、支气管肺泡灌洗液和外周血中的淋巴细胞谱。

Analysis of lymphocyte profile in lymph nodes, bronchoalveolar lavage fluid and peripheral blood in patients with stage II sarcoidosis.

机构信息

Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

出版信息

Respir Med. 2022 Dec;205:107039. doi: 10.1016/j.rmed.2022.107039. Epub 2022 Nov 8.

Abstract

OBJECTIVE

To evaluate the lymphocyte profile (LP) in lymph node puncture fluid (LNPF) of mediastinal and hilar lymph nodes, bronchoalveolar lavage fluid (BALF), and peripheral blood (PB) involved in stage 2 sarcoidosis.

METHODS

After selection, 31 patients diagnosed with stage II sarcoidosis were finally included. Patients were further divided into symptomatic (n = 17) and asymptomatic (n = 14) groups according to the presence or absence of respiratory symptoms. The LP in lymph node puncture fluid (LNPF), bronchoalveolar lavage fluid (BALF), and peripheral blood (PB) were evaluated and compared using flow cytometry. The relationship between respiratory symptoms and LP was preliminarily analyzed.

RESULTS

The proportions of T cells and CD4 T cells, and CD4/CD8 ratio in BALF were significantly higher than that of LNPF with PB (all P < 0.05). The proportions of lymphocyte cells, CD8 T cells, NK cells, and CD4/CD8 ratio in LNPF and PB were significantly different (all P < 0.05). There were significant differences in CD4 T cells [72.40 (68.90,75.55) vs.46.30 (38.55,52.50), P = 0.004], CD8 T cells (9.9 ± 3.9 vs. 16.8 ± 6.8, P = 0.002), and CD4/CD8 ratio (7.9 ± 2.8 vs. 3.9 ± 1.5, P < 0.001) in BALF between the symptomatic group and asymptomatic group (all P < 0.05). The T cells (rs = 0.447, P = 0.011), CD4 (rs = 0.572, P = 0.002), and CD4/CD8 ratio (rs = 0.701, P < 0.001) in BALF were positively correlated with respiratory symptoms.

CONCLUSION

The LP in LNPF, BALF and PB were significantly different and the main index correlated with respiratory symptoms was CD4/CD8 ratio in BALF. The difference of LP in BALF and LNPF may help to deeply understand the pathophysiological process and may reflect the different degree of lung and lymph node lesion.

摘要

目的

评估 2 期结节病患者的纵隔和肺门淋巴结穿刺液(LNPF)、支气管肺泡灌洗液(BALF)和外周血(PB)中的淋巴细胞谱(LP)。

方法

经过选择,最终纳入 31 名被诊断为 2 期结节病的患者。根据是否存在呼吸症状,患者进一步分为有症状(n=17)和无症状(n=14)组。使用流式细胞术评估和比较淋巴结穿刺液(LNPF)、支气管肺泡灌洗液(BALF)和外周血(PB)中的 LP,并初步分析呼吸症状与 LP 的关系。

结果

BALF 中的 T 细胞和 CD4 T 细胞比例以及 CD4/CD8 比值明显高于 LNPF 和 PB(均 P<0.05)。LNPF 和 PB 中淋巴细胞、CD8 T 细胞、NK 细胞和 CD4/CD8 比值的比例明显不同(均 P<0.05)。BALF 中 CD4 T 细胞[72.40(68.90,75.55)比 46.30(38.55,52.50),P=0.004]、CD8 T 细胞(9.9±3.9 比 16.8±6.8,P=0.002)和 CD4/CD8 比值(7.9±2.8 比 3.9±1.5,P<0.001)在有症状组和无症状组之间存在显著差异(均 P<0.05)。BALF 中 T 细胞(rs=0.447,P=0.011)、CD4(rs=0.572,P=0.002)和 CD4/CD8 比值(rs=0.701,P<0.001)与呼吸症状呈正相关。

结论

LNPF、BALF 和 PB 中的 LP 存在显著差异,与呼吸症状相关的主要指标是 BALF 中的 CD4/CD8 比值。BALF 和 LNPF 中 LP 的差异可能有助于深入了解病理生理过程,并可能反映肺部和淋巴结病变的不同程度。

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