系统性红斑狼疮CD8^+ T细胞CD28表达与中医分型的关系

Relationship between CD8^+ T-cell CD_(28) Expression and TCM Differentiation Type in Patients withsystemic lupus erythematosus

目的:探讨系统性红斑狼疮(SLE)外周血CD8+T细胞CD28分子的表达与不同中医证型的关系。方法:采用流式细胞术,分别对24例热毒炽盛患者,16例肝肾阴虚患者和20例对照组外周血CD8+T细胞CD 28分子的表达水平进行测定,常规检测SLE病人疾病活动性评分(SLEDAI)、C反应蛋白(CRP)、补体、免疫球蛋白。结果:与正常对照组比较,SLE中医两型CD8+、CD8+CD28-及CD8+CD28-/CD8+CD28+比值升高,CD8+CD28+比例下降,差异有显著性意义(P<0.05或P<0.01);与热毒炽盛组比较,肝肾阴虚组CD8+CD28+、CD8+CD28-比例升高,C3、C4升高,SLE-DAI、CRP下降,差异有显著性意义(P<0.05或P<0.01);经直线相关分析,SLEDAI、C4与CD8+CD28+相关性非常显著(P<0.05)。结论:外周血CD8+T细胞CD28分子的表达水平变化与SLE中医证型具有一定相关性,可作为SLE中医辨证分型的客观化指标。

Objective：To explore the relationship between CD8^＋ T-Cell CD28 molecular expression in peripheral blood and Traditional Chinese medicine（TCM） Differentiation Type in patients with systemic lupus erythematosus（SLE）.Methods：Using flow cytometry to detect the CD28 expression in 24 Excess of Noxious Heat Type,16 Liver-Kidney Yin deficiency Type in Patients with SLE and 20 healthy people for control.SLEDAI,CRP,complement and immune globulin were tested routinely.Results：Compared with control,the two TCM Differentiation Type had significantly higher percentage of peripheral blood CD8^＋,CD8^＋CD28^-and CD8^＋CD28^-/CD8^＋CD28^＋,and got significantly decreased percentage of CD8^＋CD28^＋（P〈0.05 or P〈0.01）.Compared with the Excess of Noxious Heat Type,the levels of CD8^＋CD28^＋,CD8^＋CD28^-were all higher in the SLE patients of Liver-Kidney Yin deficiency Type,and so were C3,C4,but SLEDAI,CRP were significantly lower（P〈0.05 or P〈0.01）.The CD8^＋CD28^＋ had a significant correlation with SLEDAI,C4（P〈0.01）.Conclusion：Changes of CD8^＋T-Cell CD28 molecular expression in peripheral blood might be associated with the TCM Differentiation Type of SLE.So they can be taken as objective markers for TCM Differentiation Type of SLE.