慢性胃炎脾胃湿热证与外周血Th1/Th2平衡的研究

Study of Th1/Th2 Balance in Peripheral Blood of Chronic Gastritis Patients with Pi-Wei Damp-Heat Syndrome

目的探讨慢性胃炎脾胃湿热证与外周血Th1/Th2平衡的相关性。方法收集慢性胃炎脾胃湿热证患者51例(包括湿重于热22例,热重于湿9例,湿热并重20例),另设健康志愿者10名为健康对照组。采用安速Hp血清快速检测法判定Hp感染率,液相蛋白芯片技术检测血清Th1型细胞因子γ干扰素(inter-feron-γ,IFN-γ)、白细胞介素12(interleukin-12,IL-12)和Th2型细胞因子IL-4、IL-10表达。结果脾胃湿热证组患者Hp感染率(41.18%,21/51)明显高于健康对照组(10.00%,1/10),差异有统计学意义(P<0.05)。湿重于热、热重于湿和湿热并重各亚型组Hp感染率分别为45.45%(10/22)、22.22%(2/9)和45.00%(9/20),其中湿重于热、湿热并重亚型组与健康对照组比较,差异有统计学意义(P<0.05)。脾胃湿热证患者外周血IFN-γ、IL-12、IL-4及IL-10表达与健康对照组比较,差异均无统计学意义(P>0.05),但脾胃湿热证IFN-γ和IL-12表达呈增高的趋势,而IL-4表达则呈下降的趋势。脾胃湿热证各亚型组比较,均呈现湿热并重组IFN-γ、IL-12、IL-4表达以及IFN-γ/IL-4、IL-12/IL-4比值较湿重于热组、热重于湿组升高的趋势,但差异无统计学意义(P>0.05)。结论慢性胃炎脾胃湿热证的发生可能与Th1/Th2平衡改变相关,"湿"和"热"邪可能是介导Th1型细胞因子免疫反应的病理因素。

Objective To study the correlation between the Th1/Th2 balance in the peripheral blood and Pi-Wei damp-heat syndrome（PDS） in chronic gastritis（CG） .Methods Fifty-one patients with CG of PDS were recruited,including 22 cases with predominant damp（PDS-D） ,9 case with predominant heat（PDS-H） ,and 20 case with simultaneous onset of damp and Heat（PDS-DH） .Besides,10 healthy volunteers were recruited as the healthy control group.H.pylori（HP） infection was detected by fast urea enzyme,and the expressions of Th1 type cytokines interferon-γ（IFN-γ） ,interleukin-12（IL-12） ,and Th2 type cytokines interleukin-4（IL-4） ,interleukin-10（IL-10） in serum were detected by luminex technology.Results The HP infection rate was 41.18%（21/51） in the PDS patients,obviously higher than that in the healthy control group（10.00%,1/10） ,showing statistical difference（P0.05） .The HP infection rate was 45.45%（10/22） in PDS-D,22.22%（2/9） in PDS-H,and 45.00%（9/20） in PDS-DH.The HP infection rate in PDS-D and PDS-DH was significantly higher than that of the healthy control group,showing statistical difference（P0.05） .There was no statistically significant difference in the expressions of peripheral blood IFN-γ,IL-12,IL-4,and IL-10 between the PDS patient group and the healthy control group（P0.05） .But the expressions of IFN-γ and IL-12 showed an increasing trend in the PDS patient group,while the expression of IL-4 showed a decreasing trend.The expressions of IFN-γ,IL-12,IL-4,and the ratios of IFN-γ/IL-4 and IL-12/IL-4 were also higher in PDS-DH group than in the PDS-D group and the PDS-H group,but with no statistical significance（P0.05） .Conclusion The occurrence of Pi-Wei damp-heat CG was possibly correlated with the imbalance of Th1/Th2.Damp and heat pathogen might be important pathogenic factors leading to Th1 type cytokine immunoreaction.