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目的 探讨结核性胸膜炎外周血和胸水中Th17细胞和白细胞介素-17(IL-17)的表达水平及临床意义.方法 初治结核性胸膜炎(结核组)患者30例和非结核性胸膜炎(胸膜炎组)20例,另选择健康体检人员(对照组)20例.采用流式细胞术和双抗体夹心免疫酶标法(ELISA)测定血清及胸水中Th17细胞的百分率及IL-17的含量.结果 结核组外周血中Th17细胞的百分比和IL-17的含量显著高于对照组和胸膜炎组(P＜0.05).结核组胸水中Th17细胞的百分比和IL-17的含量明显高于胸膜炎组(P＜0.05).结核组患者在规则治疗1、3、7、14 d时,外周血和胸水中Th17细胞的百分比和IL-17的含量均逐渐下降,外周血中TH17细胞的百分比于治疗1d时显著低于入院时水平(P＜0.05),胸水中Th17细胞的百分比于治疗3d时显著低于入院时水平(P＜0.05),外周血中IL-17的含量于治疗3d时显著低于人院时水平(P＜0.05),胸水中IL-17的含量于治疗7d时显著低于入院时水平(P＜0.05).结论 Th17/IL-17参与了结核性胸膜炎的发病机制,且与其病程发展及治疗效果密切相关.

Objective To investigate the blood and chest fluid level of Th17 cell and IL-17 in patients with tuberculous pleural effusion and its pathological role.Methods Flow cytometry and enzyme linked immunosorbent assay (ELISA) were used to measure the blood and chest fluid level of Th17 cell and IL-17 from 30 patients with tuberculous pleural effusion,20 patients without tuberculous pleural effusion,and 20 healthy persons.Results The blood level of Th17 cell and IL-17 wwere higher in tuberculous pleural effusion than in the other two groups(P ＜0.05).The chest fluid level of Th17 cell and IL-17 in patients with tuberculous pleural effusion were significantly higher than those in patients without tuberculous pleural effusion (P ＜ 0.05 ).The chest fluid level of Th17 cell and IL-17 in patients with and without tuberculous pleural effusion were significantly higher than that of the blood serum level.After treatment for 1,3,7 and 14 days,tbe blood serum and chest fluid level of Th17 cell and IL-17 were obviously lower.( P ＜ 0.01 ).After treatment for 1 day,the blood level of Th17 cell was obviously lower than before treatment( P ＜ 0.01 ).After treatment for 3 days,the chest fluid level of Th17 cell was obviously lower than before treatment( P ＜0.01 ).After treatment for 3 days,the blood serum level of IL-17 was obviously lower than before treatment (P ＜ 0.01 ).After treatment for 7 days,the chest fluid level of IL-17 was obviously lower than before treatment ( P ＜0.01 ).Conclusion Th17 cell and IL-17 might play an important role in the pathogenesis of tuberculous pleural effusion and they were correlated with disease progression and the therapeutic effect.