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临床上结核性胸膜炎易发生胸膜纤维化,对患者肺功能产生不同程度的影响。胸膜纤维化的发病中,胸膜间皮细胞、成纤维细胞、凝血纤溶系统及各种细胞因子相互联系,互为调节影响,发挥重要的作用。结核性胸膜炎发病后的临床进展过程亦与宿主的免疫反应密切相关,CD4+Th3细胞、CD4+Tr1细胞及CD4+CD25+FoxP3+T细胞在结核病程中可能因抑制CD4+Th1细胞免疫应答功能,从而有利于结核病的感染持续,促进胸膜纤维化的形成。目前对机体在结核性胸膜炎发病中的免疫反应研究仍多局限于CD4+Th1/Th2细胞的关系,对其他调节性T细胞的免疫调节作用研究报道较少。文中综述结核性胸膜纤维化机制研究进展,介绍间皮细胞及其分泌物、凝血纤溶系统、细胞因子及调节性T细胞CD4+Th3细胞、CD4+Tr1细胞及CD4+CD25+FoxP3+T细胞的免疫调节作用。
Clinically pleural tuberculosis prone to pleural fibrosis, pulmonary function in patients with varying degrees of impact. In the pathogenesis of pleural fibrosis, pleural mesothelial cells, fibroblasts, coagulation and fibrinolysis system and various cytokines are interrelated and play an important role in the regulation of each other. The clinical progress of tuberculous pleurisy is also closely related to the host immune response. CD4 + Th3 cells, CD4 + Tr1 cells and CD4 + CD25 + FoxP3 + T cells may inhibit the immune response of CD4 + Th1 cells in the process of tuberculosis , Which is conducive to the continuation of the infection of tuberculosis and promote the formation of pleural fibrosis. At present, the study on the immune response of the body in the pathogenesis of tuberculous pleurisy is still confined to the relationship between CD4 + Th1 / Th2 cells, and few reports on the immune regulation of other regulatory T cells. This review summarizes the research progress of tuberculous pleural fibrosis, and introduces mesothelial cells and their secretions, coagulation and fibrinolysis system, cytokines and regulatory T cells CD4 + Th3 cells, CD4 + Tr1 cells and CD4 + CD25 + FoxP3 + T cells Immunomodulatory effect.