苦参碱治疗对乙肝肝硬化患者自然杀伤细胞表型变化的影响

Effect of matrine treatment on phenotypic changes of natural killer cells in patients with hepatitis B cirrhosis

目的:通过研究经苦参碱治疗的乙肝肝硬化患者外周血自然杀伤细胞(NK细胞)表型变化,探讨苦参碱对乙肝肝硬化患者NK细胞的作用。方法:50例乙肝肝硬化患者按中医辨证分为湿热型和非湿热型两组,并设健康对照。应用流式细胞术检测苦参碱治疗一个月前后患者外周血自然杀伤细胞表面活化性受体NKG2D、自然杀伤细胞毒性受体NKp46、自然杀伤细胞表面抑制性受体NKG2A的表达水平。结果:(1)乙肝肝硬化组外周血NKG2A表达水平高于健康对照组,NKG2D表达水平则低于健康对照组,NKp46表达水平与健康对照组相比差异无统计学意义;(2)湿热型乙肝肝硬化患者外周血NKp46、NKG2A、NKG2D均略高于非湿热型,但两组间无统计学差异;(3)经苦参碱治疗后,50例乙肝肝硬化患者外周血NKG2D表达均增多,而NKp46、NKG2A表达变化的差异无统计学意义,其中的湿热型患者外周血NKG2D表达显著增加,非湿热型NKG2D的表达变化无显著差异。结论:苦参碱治疗后乙肝肝硬化尤其是湿热型患者NKG2D表达水平增多,说明苦参碱疗效可能与NKG2D表达水平相关。

Objective： to explore the effect of matrine on natural killer cells（ NK cells） in patients with hepatitis B cirrhosis though studying the phenotypic changes of NK cells in the peripheral bloods of patients with hepatitis B cirrhosis who had received matrine treatment. Methods：50 patients with hepatitis B cirrhosis were divided into two groups such as damp-heat type and non damp-heat type according to TCM syndrome differentiation,and the healthy control group was established. The flow cytometry was used to detect the expression levels of NK cell surtace receptors such as NKG2 D,NKp46 and NKG2 A in the peripheral bloods of patients before and after receiving matrine treatment for one month,SPSS19. 0 statistical software was used for data analysis. Results：（ 1） The expression level of NKG2 A in peripheral blood in hepatitis B cirrhosis group was higher than that in the healthy control group（ P 0. 05）,there was no statistically significant difference in NKp46 expression level between the hepatitis B cirrhosis group and the healthy control group（ P 0. 05）;（ 2） the expression levels of NKp46,NKG2 A and NKG2 D in the peripheral bloods of damp-heat type patients were slightly higher than those in non damp-heat type patients,but there were no statistical differences between two groups（ P 0. 05）;（ 3） After matrine treatment,the expression levels of NKG2 D in peripheral bloods of 50 patients with hepatitis B cirrhosis were increased（ P 0. 05）,and the expression changes of NKp46 and NKG2 A had no significant differences（ P 0. 05）,of which,the expression levels of NKG2 D in peripheral bloods of damp-heat type patients were significantly increased（ P 0. 01）,the expression change of NKG2 D in non damp-heat type patients had no significant difference（ P 0. 05）.Conclusion： After matrine treatment,the expression level of NKG2 D was increased in hepatitis B cirrhosis patients,especially in damp-heat type patients,indicating that the efficacy of matrine may be related to the expression level of NKG2 D.