Background:The incidence of spinal infections is increasing; However, pathogen identification remains challenging. Although Q fever spinal infection is reported infrequently, its accrual incidence is likely underestimated. The causative agent, Coxiella burnetii, cannot be routinely cultured. Consequently, physicians often misdiagnose Q fever spinal infection as spinal tuberculosis, leading to severe patient harm. Thus, improving clinicians' awareness of the clinical characteristics of Q fever spinal infection is urgently needed. Methods:We present a case of Q fever spinal infection and conducted literature searches in PubMed and the Chinese core journals of the Wanfang Database using keywords including "Q fever," "Coxiella burnetii," "spinal infection," "osteomyelitis," "spondylodiscitis," and "psoas abscess." Additional reports were identified through cross-referencing, with a cutoff date of 6 November 2024. Cases were included if patient age, sex, and baseline medical history were documented. Clinical data were retrospectively analyzed, and clinical features were compared between the aneurysm-associated group and the isolated spinal infection group. Fisher's exact probability test was used to evaluate the incidence difference. Results:A total of 39 adult patients were enrolled (mean age: 67.82 ± 10.51 years, male: 34,87.2%), Eleven cases reported potential pathogen exposure. Thirty-three cases presented with early-onset of lower back pain, and 13 developed fever during the disease course. Thirty-four cases involved the lumbar spine, exhibiting continuous lesions of 1-3 vertebral bodies, with imaging features of vertebral osteomyelitis, discitis, paravertebral soft-tissue swelling, and/or adjacent aneurysmal changes. Among 21 cases with routine blood tests, 2 showed elevated leukocyte counts, 5 had mild anemia, and the remainder were normal. Serological testing was performed in 34 cases, with 29 testing positive on the first time; PCR testing was conducted in 25 cases, with 23 cases detecting positive specimens; and rapid diagnosis confirmed in all 3 cases via metagenomic next-generation sequencing (mNGS). Inflammatory reactions were identified in all 21 biopsied cases, with inflammatory granulomas reported in 7 and explicitly excluded in 4. There were 24 cases complicated with aneurysm and 15 cases with isolated spinal infection. A significant difference in CRP elevation rate was observed between the two groups (14/15, 93.33% vs 4/8, 50.00%, P = .033). Early local lesion debridement combined with doxycycline-based multidrug therapy showed favorable outcomes. Serological monitoring demonstrated low sensitivity for assessing therapeutic efficacy. Conclusions:This study systematically summarizes the clinical characteristics of Q fever spinal infection and, for the first time, reports features associated with its distinct clinical subtypes. Q fever should be considered in case of chronic spinal infections-especially those complicated with vascular lesions. Based on clinical history evaluation, rapid diagnosis may be achieved through mNGS of specimens from local lesions. Combined with early initiation of doxycycline-based regimens, timely debridement of necrotic tissues and purulent material may improve treatment outcomes. Further investigations are needed to identify reliable biomarkers for monitoring therapeutic efficacy and to establish optimal treatment strategies for subtypes of Q fever spinal infection.

What is known and objective Tuberculous meningitis (TBM) is one of the most serious types of extrapulmonary tuberculosis and has caused distress to human. Effective treatment is particularly important. The aim of this meta-analysis is to compare the efficacy of high-dose and standard-dose rifampicin. Methods Databases including PubMed, Web of Science, Embase, Scopus and the Cochrane Library databases were electronically searched to identify randomized controlled trials that reported high-dose rifampicin in treatment of patients with TBM. The retrieval time is limited from inception to June 2021. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Meta-analysis was performed by using STATA 12.0 software. Results and discussion A total of 12 studies involving 1596 patients were included. The meta-analysis results showed no significant differences in 6-month mortality, 9-month mortality, Grade I-II AE, Grade III-V AE, hepatotoxicity, hepatotoxicity Grade I-II and cardiologic events between high-dose rifampicin (or high-dose rifampicin plus moxifloxacin or levofloxacin) and standard-dose groups. The log(C-max) (WMD 0.69, 95%CI 0.59-0.79, p 0.001) and log(AUC(0-24h)) (WMD 0.79, 95%CI 0.71-0.88, p 0.001) were higher with high-dose rifampicin. Subgroup analysis revealed the rise of log(C-max) in high-dose rifampicin orally was consistent with intravenous administration compared with the control (WMD 0.69, 95%CI 0.66-0.73, p 0.001). What is new and conclusion High-dose rifampicin was not a protective factor for 6-month mortality, despite increased plasma C-max and AUC(0-24h). However, the above conclusions are still required to be verified through more RCTs due to the limited quantity of included studies.

Objective Latent tuberculosis infection (LTBI) may be a risk of developing tuberculosis (TB) and thus a health hazard. The aim of this meta-analysis is to explore the association between vitamin D and LTBI. Methods Databases including PubMed, Embase, Scopus, and ProQuest were electronically searched to identify observational or interventional studies that reported the association between vitamin D and LTBI. The retrieval time is limited from inception to September 2021. Two reviewers independently screened literature, extracted data, and assessed risk bias of included studies. Meta-analysis was performed by using STATA 12.0 software. Results A total of 5 studies involving 2 case-control studies and 3 cohort studies were included. The meta-analysis result showed that the serum level of vitamin D was associated with the risk of LTBI (OR=0.32, 95%CI: 0.12-0.85, P=0.022). The result from cohort studies suggested that relatively high vitamin D level was a protective factor for LTBI (RR=0.67, 95%CI: 0.48-0.92, P=0.015). Conclusions Our meta-analysis suggested that serum vitamin D levels were associated with LTBI, and relatively high serum vitamin D level was a protective factor for LTBI. Further RCTs are needed to verify whether vitamin D supplementation prevents LTBI.

Objective:To investigate the clinical characteristics of a fulminant respiratory infection caused by human adenovirus type 55 (HAdV-55) in Beijing, and to raise the awareness and level of diagnosis and treatment of HAdV-55 respiratory infection.Methods:Total of 48 patients diagnosed as acute HAdV-55 respiratory tract infection were treated in The 8th Medical Center of PLA General Hospital. The clinical information of patients were collected and analyzed, retrospectively, including symptoms, signs, results of laboratory examination [including blood routine, erythrocyte sedimentation rate, C-reactive protein (CRP), blood biochemistry, pathogen nucleic acid detection, etc.], treatment methods and prognosis. Patients were divided into pneumonia group (18 cases) and upper respiratory tract infection group (30 cases) according to with or without variative lung lesions on CT image. Data with normal distribution of before and after treatment of the two groups were compared with paired t test, and the proportion of symptom distribution were analyzed by chi-square test or Fisher exact probability test.Results:The average age of 48 patients was (20.6 ± 1.8) years old, and 83.3% (40/48) cases were initial entry to Beijing from urban or rural areas below secondary level. There were 58.3% (28/48) patients with the highest body temperature > 39℃, including 12 cases in pneumonia group and 16 cases in upper respiratory tract infection group (χ2 = 0.823, P = 0.346); 84.6% (22/26) patients with sputum had yellow sputum, including 11 cases in pneumonia group and 11 cases in upper respiratory tract infection group (χ2 = 0.142, P = 0.706), both without significant differences. Excepte for 6 patients treated for longer than 4 d, the average number of peripheral white blood cells in 42 patients was (9.03 ± 0.37) × 109/L, there was no significant difference between pneumonia group [(9.08 ± 3.01) × 109/L] and upper respiratory tract infection group [(9.01 ± 2.02) × 109/L](t =-0.086, P = 0.932). Leukocyte count in 38.1% (16/42) patients were > 10 × 109/L. The average CRP of 42 patients at first visit was (29.0 ± 17.2) mg/L, but there was no significant difference between pneumonia group [(30.2 ± 13.7) mg/L] and upper respiratory tract infection group [(28.3 ± 19.0)mg/L](t =-0.338, P = 0.737). The focus of pneumonia was basically located in the extrapulmonary zone, close to or connected to the pleura. Seven days after the patient’s temperature returned to normal, 7 cases were positive for HAdV nuclear acid among the 8 cases re-measured.Conclusions:With high fever, yellow sputum, increased white blood cell and neutrophil count, and normal lymphocyte count, acute respiratory infection caused by HAdV-55 showed the characteristics of bacterial infection. The virus nucleic acid remains contagious within one week after the recovery of body temperature.

目的 总结分析人腺病毒B组55型肺炎的CT表现.方法 选取解放军总医院第八医学中心2020年2月收治的44例确诊为人腺病毒肺炎B组55型患者,分析总结28例有肺部炎症患者的胸部CT影像资料.结果 28例患者肺部单发病例18例,占64.28％;发现肺部病变36处,其中下叶病变26处,占72.23％;病变位置多位于肺外带胸膜下区;肺炎形态多种多样,而且多发病变形态共存,以片状、及磨玻璃样密度影较多,28例患者共发现上述改变25例,占89.29％.病变可累及支气管和胸膜,致使支气管壁增厚、胸膜增厚等.结论 人腺病毒B组55型肺炎影像表现有明显特异性,一般表现为肺外带片状及磨玻璃样改变,是与其他肺炎的鉴别点.

目的 分析首次诊断为淋巴结结核病例的脓液病原学诊断特点,为临床医生提供选择诊断方法的理论依据.方法 收集我中心结核临床实验室2016年1月—2017年12月所有淋巴结结核脓液标本的病例资料,从中选出首诊时在超声引导下或无超声引导下用注射器穿刺抽脓的初诊淋巴结结核病例51例.分析病例的相关临床资料,包括性别、年龄、病原学检验结果、病理学结果、影像学结果等.结果 51例病例中,女性31例;年龄18～78岁,平均为(33.0±13.7)岁,20～30岁者占54.8％;肺部CT无异常表现的有32例;15例病例行细针穿刺病理学检查,呈典型干酪样坏死改变3例.将同时行脓液结核分枝杆菌核酸检测(nucleic acid amplifi cation tests,NAAT)和抗酸染色涂片的标本检测结果进行比较,NAAT阳性率为88.2％,抗酸染色涂片阳性率为19.6％,2者比较差异有统计学意义(P<0.05);将同时行结核分枝杆菌NAAT和分枝杆菌快速培养的标本检测结果进行比较,NAAT阳性率为91.3％,分枝杆菌快速培养阳性率为30.4％,2者比较差异有统计学意义(P<0.05).结论 对于淋巴结结核的诊断,将抽吸的脓液行NAAT可以作为首选诊断方法.

Mycobacterium tuberculosis is an age-old bacterium that is difficult to eliminate. A simple and rapid diagnostic method is of great importance to prevent the spread of M. tuberculosis. Here, we developed a low-cost rapid M. tuberculosis nucleic acid detection technique, named GenePop, which enabled the storage and transport of M. tuberculosis diagnostic reagent at ambient temperatures, without the need for professional operations or expensive instrumentation. Using a vitrification method, we vitrified heat-unstable components onto the cap of a reaction tube, and placed heat-stable components at the bottom of the reaction tube by sealing them with paraffin wax. The all-in-one detection tube, when used together with our other invention-a multi-functional sample treatment tube pre-filled with a nucleic acid-releasing agent-only required three simple steps to yield results. A comparative analysis with a commercial qPCR kit for M. tuberculosis indicated that our new technique had a concordance rate of 91.6%, showing no cross-reactivity with 11 other bacteria. The complete operation time was only 65 min. It is suitable for use in field settings or by personnel in grass-root units, and is applicable in household activities, hence can be used in developing countries.

目的 研究309医院结核病研究所接收的肺病病人中非结核分枝杆菌(NTM)肺病的菌种分布及病例特点,为临床诊断提供思路.方法 收集309医院结核病研究所临床实验室2014年9月至2018年3月非结核分枝杆菌阳性报告,根据2012年版中华医学会《非结核分枝杆菌病诊断与治疗专家共识》建立确诊NTM肺病组,研究NTM肺病组中NTM的分布特点;根据NTM肺病组病例的年龄、性别、地域和发病时限建立配对肺结核组,研究两组病人基础状态的差别.结果 NTM阳性108例,分离率为4.66％.确诊NTM肺病72例,分离率为3.10％,90％病例来自华北和东北地区.包括胞内分枝杆菌(33/72,45.8％oo),龟/脓肿分枝杆菌(27/72,37.5％),鸟分枝杆菌(7/72,9.7％),堪萨斯分枝杆菌(3/72,4.2％),蟾蜍分枝杆菌(2/72,2.8％).NTM肺病患者明确诊断用时平均27.8±30.8个月;平均年龄64.1±18.0岁;男女比例1.88∶1;＞80岁组全部为男性,11/13为龟/脓肿分枝杆菌肺病;NTM肺病患者的基础性呼吸系统慢性疾病发生率高于肺结核病患者,差异有统计学意义(X2 =4.141,P=0.042);女性NTM肺病的基础性支气管扩张发生率显著高于男性NTM肺病患者(x2=10.277,P=0.006).龟/脓肿分枝杆菌肺病平均年龄75.2±14.8岁,胞内NTM肺病患者平均年龄59.9±17.0岁,这两种肺病的年龄分布差异有统计学意义(x2 =14.832,P=0.011).结论 华北东北地区主要的NTM肺病致病菌是胞内分枝杆菌和龟/脓肿分枝杆菌;40岁之后NTM肺病发病率随年龄增多;80岁之后以龟/脓肿分枝杆菌为主;女性NTM肺病发病年龄相对小,基础性支气管扩张是女性NTM肺病的易感因素;NTM肺病明确诊断用时长,分枝杆菌核酸检验可以显著提高诊断效率.

Objective:To explore the relationship between CD244 and the phenotype and function of CD56bright NK cells of patients with active pulmonary tuberculosis.Methods: PBMCs were isolated from peripheral blood by density gradient centrifugation.The expression of CD244,CD94,NKG2D on the CD56bright NK cells from the active pulmonary tuberculosis patients and healthy controls was detected by flow cytometry.And then analyzed the relationship of the expression of CD244 with Tim3,CD27,CD62L,CCR7,IFN-γ and CD107a in CD56bright NK cells by flow cytometry.Results: The expression of CD244 on the CD56bright NK cells showed no significant difference between the patients with active pulmonary tuberculosis and healthy controls without MTB antigen.The expression of CD244 was significantly increased on CD56bright NK cells of patients with tuberculosis stimulated with MTB antigen.The expression of CD94 and NKG2D on CD56bright NK cells showed no difference between patients and healthy controls.The proportion of Tim3+ cells in CD244+CD56bright NK cells was significantly higher than CD244-CD56bright NK cells.While the expression of CD62L and IFN-γ decreased significantly in CD244+CD56bright NK cells.The expression of CD107a on CD56bright NK cells was not significantly different between CD244+ cells and CD244-cells.Conclusion: The expression of CD244 on CD56bright NK cells in patients with active pulmonary tuberculosis increased significantly,maybe inhibit IFN-γ co-work with Tim3.CD244 has nothing to do with degranulation of CD56bright NK cells.

This report describes a case of Tsukamurella pneumonia in a 24-year-old immunocompetent woman. The patient was diagnosed as having pulmonary tuberculosis and was treated for nearly 9 months. The correct diagnosis was suspected only when the results of mycobacteria nucleic acid amplification tests on cultural colonies were negative. Tsukamurella was identified from the patient's sputum and bronchoalveolar lavage fluid by using 16S rRNA sequence analysis. Here, the clinical presentation, diagnosis, and treatment strategies of Tsukamurella pneumonia are discussed, along with a literature review. Tsukamurella pneumonia may be highly underdiagnosed owing to its similarity with pulmonary tuberculosis and the habitual thinking of doctors in countries with a high tuberculosis burden. Tsukamurella should be carefully considered in the etiology of tuberculosis-like lung diseases.

ObjectiveTo evaluate the diagnostic performance of smear method based on liquid-based cytology in detecting acid-fast bacilli in clinical specimens of different types.MethodsA total of 200 samples including 148 samples of morning sputum and 52 samples of body fluid, which were collected from patients within one week since they were hospitalized, were examined for acid-fast bacilli by direct smear method and liquid-based smear method at the same time. The positive rates of the two methods were compared.ResultsSixteen repeated samples and 9 samples without being cultured for acid-fast bacilli were excluded, so 123 samples of morning sputum and 52 samples of body fluid were included. As for 123 sputum samples, the positive rates were 33.33% for liquid-based smear method and 24.39% for direct smear method, and the difference was significant (P=0.012); the positive rates were 58.82% for liquid-based smear method and 44.12% for direct smear method in culture-confirmed sputum samples, and the difference was significant (P=0.018). As for 52 samples of body fluid, the positive rates were 13.46% for liquid-based smear method and 1.96% for direct smear method, and the difference was significant (P=0.041); 7 samples were positive for liquid-based smear method and 1 for direct smear method in culture-confirmed sputum samples (16 samples), and the difference was significant (P=0.040).ConclusionsThe positive rate of detecting acid-fast bacilli by liquid-based smear method is higher than that by direct smear method, especially for body fluid specimens. The liquid-based smear method is useful for clinical rapid diagnosis. However, for the sputum specimens, the examination time and the cost should be considered.

Objective To study the role of CD244 in CD8 + T cells of patients with active pulmonary tuberculosis.Methods Peripheral blood mononuclear cells (PBMCs) were isolated from patients with active tuberculosis and healthy controls.The expression of CD244 in CD8 + T cells was examined by flow cytometry.The relationships of CD244 with IFN-γ and TNF-α were analyzed by intracellular cytokine staining.Results The expression of CD244 in CD8 + T cells from patients with tuberculosis was significantly higher than that of healthy controls (P =0.0003),and the expression of CD244 in CD8 + T cells of retreatment tuberculosis patients was significantly higher than that of new patients(P =0.0011).The expression of IFN-γ and TNF-α was significantly higher in CD244-cells than that in CD244 + cells (P =0.0013,P =0.0016).Conclusions CD244 inhibited cytokine production of CD8 + T cells in patients with active pulmonary tuberculosis.

Background: Commercial serological tests for the diagnosis of tuberculosis (TB) show poor sensitivity and specificity, and a new approach to antigen screening is required to improve the accuracy of serodiagnosis. Methods: Using an indirect enzyme-linked immunosorbent assay (ELISA), we evaluated the responses of IgG and IgM antibodies to the recombinant PstS1-LEP protein expressed in Escherichia coli, a polyprotein of PstS1 and line multi-epitopes polypeptide (LEP). Results: The mixture of anti-human IgG and IgM added to a well [Ig(G + M)], which was different from the combination of IgG and IgM (IgG + IgM), had a stronger immunoreactivity to PstS1-LEP than the single antibody. IgG and Ig(G + M), but not IgM against the PstS1-LEP protein effectively distinguished TB patients from patients with nontuberculous pulmonary disease (NTBPD) and healthy controls (HCs). Compared with IgG, the sensitivities of Ig(G + M) and IgG + IgM varied from 71.4% to 77.6% and 72.7% in pulmonary TB (PTB) patients and from 42.1% to 64.0% and 55.8% in extrapulmonary TB (EPTB) patients, respectively. The specificity of Ig(G + M) did not decrease, and was higher than that provided by IgG + IgM in HCs with positive tuberculin skin test. Conclusion: These findings suggest that PstS1-LEP can act as a candidate for detecting Ig(G + M) in serum from PTB and EPTB patients.

Objective To provide the bacteriological basis for improving the use of rifamycins by analyzing the characteristics of resistance of clinically isolated Mycobacterium tuberculosis (Mtb) to rifamycins. Methods Absolute concentration method was per-formed to detect resistance of Mtb in 470 clinical isolates. Results Of 180 samples positive for Mtb, 41 were resistant to rifamycins. The resistance levels of Mtb in clinical isolates to rifampicin and rifapentine were highly consistent, and they were significantly higher than that to rifabutin. The numbers of samples with resistance of Mtb to rifabutin at a low concentration were significantly different from those to rifabutin at a high concentration. Conclusions The result that the resistance of Mtb to rifampicin is highly consistent with that to rifapentine suggests that rifapentine should not be suitable to replace rifampicin after Mtb is resistant to rifampicin;rifabutin should be able to replace rifampicin, but the dose of rifabutin may affect the therapeutic efficacy.

Objective To detect antigen-specific INF-γsecreting cells in CSF by ELISPOT assay to deter-mine its clinical value for TBMdiagnosis.Methods The study selected 1 04 patients with tuberculous meningitis and 40 people without tuberculous meningitis to detect their INF-γsecreting cells in CSF and blood by ELISPOT assay. Then the results were compared with AFB staining,Mtb culture,quantitative PCR,and Mtb antibodies.Results The sensitivity of CSF-ELISPOT assay was 92.3%,the specificity was 94.1%,which were higher than other assays (P<0.05).The CSF-ELISPOT assay was better than other assay in the diagnosis of TBM (Kappa=0.856,P<0.001 ).Conclusion The CSF-ELISPOT assay,with high sensitivity and specificity,will be a rapid diagnostic method for TBM.

Obejective To study the diagnostic value of loop-mediated isothermal amplification( LAMP) in different tuberculosis clinical samples. Methods LAMP was used to detect mycobacterium tuberculosis complex-specific gene IS1081 in bronchoalveolar lavage fluid ( BALF ) , puncture fluid, ascites, and cerebrospinal fluid ( CSF) . And the result was compared with real-time PCR ( RT-PCR) . Results The sensitivity of LAMP was lower than RT-PCR (80% vs 92%) in BALF and puncture fluid, in which there were more bacteria. The sensitivity of LAMP was higher than RT-PCR (34. 6% vs 15. 4%) in ascites and CSF, in which the mount of bacteria was ex-tremely low, but the specificity of LAMP decreased slightly (80% vs 93. 3%). The sensitivities of LAMP and RT-PCR calculated in all samples showed no significant difference ( 56. 9% vs 52. 9%) . Conclusion LAMP has high sensitivity and specificity in detecting mycobacterium tuberculosis complex.

Objective To assess the diagnostic value of IGRA for latent tuberculosis infection in solid organ transplant recipients. Methods We searched PubMed,EMBASE and Cochrane library to evaluate the evidence of using QuantiFERON-TB Gold in-tube ( QFT-IT ) and T-SPOT on blood for the diagnosis of latent tuberculosis infection in solid organ transplant recipients. Meta Disc 1.4 was used to handle data from included studies. Results The search identified 6 eligible studies that included 751 transplant recipients before transplantation. Compared with TST , the summary values of specificity , sensitivity , positive likelihood ratio , negative likelihood ratio , OR , and SROC curve of QFT-IT and T-SPOT were 81%,74%,3.94,0.33,12.44,0.847 8 and 78%,75%,3.61,0.32,12.07,0.845 0, respectively. Conclusion IGRA in their current formulations has limited accuracy in diagnosing latent tuberculosis infection in transplant recipients , and should not be used alone to rule out or rule in latent tuberculosis infection in transplant recipients. Further modification is needed to improve their accuracy.

RATIONALE:Mucosal-associated invariant T (MAIT) cells have been proven to play an important role in host defense against mycobacterial infection in animal infection models; however, the functional role of MAIT cells in patients with active tuberculosis (TB) is still largely unknown.OBJECTIVES:To understand the clinical features and functions of MAIT cells in patients with active TB.METHODS:MAIT cells were analyzed in patients with pulmonary TB, tuberculous pleurisy, and tuberculous peritonitis by flow cytometry. The functions of MAIT cells were compared between patients with active TB and healthy control subjects.MEASUREMENTS AND MAIN RESULTS:The frequency of MAIT cells was significantly reduced both in peripheral blood from patients with active pulmonary TB (P < 0.0001) and in tuberculous pleural effusions compared with healthy control subjects but not in ascitic fluids from patients with tuberculous peritonitis. A comparison of bacillus Calmette-Guérin (BCG)-stimulated cytokine production showed that patients with active TB had significantly higher production of IFN-γ (P = 0.0034) and tumor necrosis factor (TNF)-α (P = 0.0399) compared with healthy control subjects. In contrast, when MAIT cells were stimulated with Escherichia coli, patients with active TB had significantly lower production of IFN-γ (P = 0.0007) and TNF-α (P = 0.0032). MAIT cells in patients with active TB exhibited elevated expression of programmed death-1 (PD-1) (P = 0.0015), and blockade of PD-1 signaling resulted in a significantly higher frequency of BCG-stimulated IFN-γ production in MAIT cells (P = 0.0178).CONCLUSIONS:MAIT-cell immune response to antigen stimulation in patients with active TB is regulated by PD-1, which could be a potential target for TB immunotherapy.

目的 研究表面受体CD244在活动性肺结核患者抗原特异性CD8+T细胞中的功能.方法 密度梯度离心法提取活动性肺结核患者和ELISPOT阳性潜伏感染者的外周血单个核细胞,用ESAT-6和CFP-10多肽刺激PBMCs,然后用CD69标记抗原特异性细胞,通过流式细胞术检测CD244在CD3+CD8+CD69+细胞中的表达;流式细胞术分析CD244与脱颗粒相关的CD107a表达的关系;通过细胞内染色方法检测CD244与穿孔L素和颗粒酶B的关系.结果 CD244在活动性肺结核患者的CD8+T细胞表达显著高于潜伏感染者(P=0.000 5);在抗原特异性CD8+T细胞,CD244+细胞表达CD107a比例显著高于CD244-细胞(P=0.002 2);CD244+细胞表达穿孔素和颗粒酶B比例显著高于CD244-细胞(P值分别为0.021 2,0.002 3).结论 CD244促进活动性肺结核患者的抗原特异性CD8+T细胞的细胞毒作用.