乙肝后肝硬化患者中医证型与T细胞亚群、免疫球蛋白水平的相关性研究

Relationship between sydromes of ZhongYi in post hepatites cirrhosis and T-lymphocyte subsets and immunoglobulin leves

通过检测T细胞亚群和免疫球蛋白指标,探讨乙肝后肝硬化患者中医证型区分与免疫学指标的关系。选取2011年1月至2011年6月期间在我院住院的85例乙肝后肝硬化患者,进行中医证候分型,其中40例为湿热内蕴型(第1组),20例为气滞湿阻型(第2组),12例为肝肾阴虚(第3组),11例为脾肾阳虚(第4组),2例为血瘀阻络,28例健康体检者作为正常对照组,分别检测T细胞亚群及免疫球蛋白。结果:各组IgA、IgG较对照组显著上升(P<0.05,P<0.01;)。①组,CD8+、NK较对照组明显下降(P<0.05);②组CD8+显著下降(P<0.01),CD4+较对照组明显上升(P<0.05);②组与其它各组在CD4+/CD8+上两者存在显著差异(P<0.01)。中医证型与机体免疫状态密切相关,同时随着疾病的进展机体的免疫状态亦随之改变,中医证型也会有所不同。通过检测乙肝后肝硬化患者的外周血CD4+、CD8+T、CD4+/CD8+的比值以及免疫球蛋白水平,了解患者机体的免疫状态,对中医证型分型判断,临床分证治疗有重要的指导价值。

To evaluate the correlation of T cell subsets, serum immunoglobulin and complement levels with different kinds of syndromes of ZhongYi of post hepatitis liver cirrhosis, 84 patients have been diagnosed as four kinds of syndrome of Zhong Yi including 40 patients with syndrome of accumulated dampness-heat（group（1））, 20 patients with syndrome of blockade of dampness due to qistagnation（group（2））, 12 patients with syndrome of Yin deficiency of liver and kidney（group（3））, 11 patients with syndrome of Yang deficiency of spleen and kidney（group（4））. T-lymphocyte subsets（by flowcytometry） and serum immuno globulin levels were measured for all the patients. Compared with control group, the IgA.IgG levels were increased significantly in all group （P〈0.05, P〈0.01） . CD8^＋ T cells and NK amounts were decreased（P〈0.05）in group（1）. CD8 ^＋ T cells were decreased significantly （P〈0.01）, and CD4^＋ T cells were decreased （P〈0.05）in group（2）. CD4^＋/CD8^＋ ratio was signifi cantly increased in group （2） than in any other groups. The different kinds of syndrome of ZhongYi were related to status of immunity, and the syndrome of ZhongYi changed with the status of immunity. CD4^＋ , CD8^＋ , CD4^＋/CD8^＋ ratio, immunoglobulin levels determinations may help to define syndrome of ZhongYi and used to clinical diagnosis and treatment.