摘 要：
目的:探究肺结核患者外周血巨噬细胞极化特征，分析不同巨噬细胞亚型比例与病原学检测结果的关系。方法 选取2023年1月~2023年7月在中国人民解放军联勤保障部队第九二三医院感染科住院的肺结核患者及同期健康体检者，采集外周血后分离单个核细胞（peripheral blood mononuclear cells，PBMCs），收集入选者一般情况、检验结果等资料，再采用流式细胞术检测外周血总巨噬细胞和M1、M2 亚型比例；对比肺结核患者与健康对照者巨噬细胞亚型的比例；把患者分为病原学检测结果阳性或阴性两组，对比其一般情况、检验结果、巨噬细胞亚型的比例差异，并分析病原学结果与巨噬细胞亚型比例的相关性。结果 共入组30例肺结核患者和10例健康对照者，流式细胞术检测结果显示肺结核患者的总巨噬细胞比例高于健康对照者（P<0.001），M2亚型巨噬细胞高于健康对照者（P<0.05），M1/M2比值低于健康对照者（P<0.01）。30例肺结核患者中共有17例病原学检查呈阳性（17/30，56.7%），13例呈阴性（13/30，43.3%）。病原学阳性患者 M2亚型巨噬细胞比例低于病原学阴性组（P<0.01），病原学阳性患者M1/M2比值高于阴性组（P<0.05）；相关性分析显示M2亚型比例与病原学阳性结果呈负相关（P<0.05），M1/M2比值与病原学阳性结果呈正相关（P<0.05）。结论 肺结核患者外周血 M2亚型巨噬细胞比例增高，病原学阳性的肺结核患者 M2亚型巨噬细胞减少、M1/M2比值增高，说明巨噬细胞极化特征与肺结核患者机体免疫状态有关。
关键词：肺结核；外周血单个核细胞；巨噬细胞；极化；病原学
Abstract:
Objective: To investigate the polarization characteristics of macrophages in the peripheral blood of patients with pulmonary tuberculosis and analyze the relationship between the proportions of different macrophage subsets and the results of etiological examinations. Methods Patients diagnosed with pulmonary tuberculosis who were hospitalized between January 2023 and July 2023 in the department of infectious diseases of the 923rd Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, as well as healthy individuals undergoing physical examinations during the same period, were selected. Peripheral blood mononuclear cells (PBMCs) were isolated from the collected peripheral blood samples. General information and laboratory test results of the participants were gathered. Flow cytometry was used to determine the total macrophage population and the proportions of M1 and M2 subsets in the peripheral blood. The proportions of macrophage subsets were compared between patients with pulmonary tuberculosis and healthy controls. Patients were divided into groups based on positive or negative etiological examination results, and differences in general conditions, laboratory test results, and macrophage subset proportions were compared between these groups. Additionally, the correlation between etiological results and macrophage subset proportions was analyzed. Results A total of 30 patients with pulmonary tuberculosis and 10 healthy controls were enrolled. Flow cytometry revealed that the total macrophage proportion was higher in patients with pulmonary tuberculosis than in the healthy control group (P<0.001). The proportion of M2 macrophages was also higher in the patient group (P<0.05), while the M1/M2 ratio was lower ( P<0.01). Among the 30 patients with pulmonary tuberculosis, 17 had positive etiological examinations (17/30, 56.7%), and 13 had negative results (13/30, 43.3%). Patients with positive etiological results had a lower proportion of M2 macrophages compared to those with negative results (P<0.01), and a higher M1/M2 ratio (P<0.05). Correlation analysis showed a negative correlation between the proportion of M2 macrophages and positive etiological results (P<0.05), and a positive correlation between the M1/M2 ratio and positive etiological results (P<0.05). Conclusion The proportion of M2 macrophages in the peripheral blood of patients with pulmonary tuberculosis is increased. In patients with positive etiological results, there is a decrease in M2 macrophages and an increase in the M1/M2 ratio, suggesting that the polarization characteristics of macrophages are associated with the immune status of patients with pulmonary tuberculosis.
Keywords: Pulmonary tuberculosis; Peripheral blood mononuclear cells; Macrophages; Polarization; Pathogens
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