急性冠脉综合征中医证型与Th/Tregs的相关性探讨

Correlation of Traditional Chinese Medical Syndrome Differentiation of Acute Coronary Syndrome with Plasma Th/Tregs

目的探讨急性冠脉综合征(ACS)中医证型分布与Th、Tregs的主要效应分子白细胞介素-17(IL-17)、白细胞介素-35(IL-35)等的相关性。方法共纳入ACS患者143例,于入院当天以ELISA法检测血清IL-17、IL-35,超声心动图Simpson法测定LVEF值。同时进行中医辨证分型及证候积分统计。结果阳气虚证型证候积分最高,气滞血瘀证型分值最低,证型间比较差异有统计学意义(P<0.05)。阳气虚证及痰浊闭塞证IL-35水平较低,而IL-17水平较高,与气滞血瘀证和阴血虚证比较差异有统计学意义(P<0.05),而IL-35与IL-17、LVEF水平在痰浊闭塞与阳气虚证间比较差异无统计学意义(P>0.05);阳气虚证证候积分与IL-17、IL-35及NLR的相关性更明显,而BNP与各证型积分的相关性不明显。结论 ACS患者外周血IL-17、IL-35水平在一定程度上能反映ACS病情严重程度,且在各中医证型间分布呈一定规律,可作为ACS中医辨证分型参考指标。

Objective： To investigation the Th/Tregs main effect molecules IL-17 and IL-35 levels in patients with acute coronary syndrome（ACS） and to explore the correlation between them and the syndrome differentiation of ACS. Methods： 143 cases of eligible subjects were recruited. Serum IL-17 and IL-35 were detected by ELISA,and the electrocardiograph LVEF values were determined by Simpson method. TCM syndrome differentiation and syndrome scores were analyzed at the same time. Results： The syndrome scores of Yangqi deficiency group were the highest,while the Qi stagnation and blood stasis group was the lowest;the difference between them was statistically significant（P〈0.05）. The Yang deficiency group and phlegm obstruction group had lower IL-35 levels and higher levels of IL-17;there was statistically significant when compared with the other two groups（P〈0.05）,while the difference was not statistically significant in IL-35,IL-17 and LVEF levels in phlegm obstruction and Yangqi deficiency group（P〉0.05）. The correlation between syndrome scores and IL-17,IL-35 and NLR of Yangqi deficiency group was more obvious,but the correlation between BNP and the scores of each group was not obvious. Conclusion： The levels of IL-17 and IL-35 in patients with ACS can reflect the severity of the disease to a certain extent,and there is a certain regularity in the distribution of TCM syndromes,which can be used as a reference index of TCM syndrome differentiation of ACS.