特发性肺纤维化中医证素与免疫指标及肿瘤标志物的相关性

Correlation between Chinese medical syndrome elements and immune indexes, tumor markers in idiopathic pulmonary fibrosis

目的:评价特发性肺纤维化(IPF)患者的中医证素与T淋巴细胞亚群及肿瘤标志物水平的关系,以探究IPF不同证素与患者免疫功能及预后之间的可能关联。方法:纳入IPF患者,通过临床实践、查阅文献、预调查后制定IPF证候调查表,采用横断面调查、现场问卷的方式,收集患者的一般资料、症状体征,明确患者的证素。检测患者的CD3+、CD4+、CD8+T淋巴细胞水平及癌胚抗原(CEA)、癌抗原(CA)125、CA153、CA199水平,比较不同证素患者T淋巴细胞亚群、肿瘤标志物水平的差异。结果:共收集79例IPF患者的资料,选取频率>10%的证素进行分析,包括病性证素气虚、痰浊、阴虚、血瘀、热、阳虚、燥,病位证素肺、肾、脾、心。①在病性证素中,各证素患者的CD3+、CD4+、CD8+T淋巴细胞水平比较,差异均无统计学意义(P>0.05);在病位证素中,各证素患者的CD3+、CD4+、CD8+T淋巴细胞水平比较,差异均无统计学意义(P>0.05)。②在病性证素中,与阳虚证素相比,气虚、痰浊、阴虚、血瘀、热、燥证素患者的CEA、CA125水平降低(P<0.05);在病位证素中,各证素患者的CEA、CA125、CA153、CA199水平比较,差异均无统计学意义(P>0.05)。结论:IPF患者的中医证素与免疫指标之间未见明显的相关性。阳虚证素与IPF患者的肿瘤标志物水平具有一定的相关性,可能提示患者预后不佳。

Objective: To evaluate the relationship between Chinese medical syndrome elements and T-lymphocyte subsets, tumor markers in idiopathic pulmonary fibrosis(IPF), and explore the possible association between syndrome elements and immune function, prognosis in IPF. Methods: The patients with IPF were included. Through clinical practice, literature review and pre-investigation, IPF syndrome questionnaire was made. The general information, symptoms and signs of the patients were collected through cross-sectional survey and on-site questionnaire, so as to confirm the syndrome elements of the patients. The levels of CD3+, CD4+ and CD8+ T lymphocytes, carcinoembryonic antigen(CEA), cancer antigen(CA)125, CA153 and CA199 were detected, and the levels of T lymphocyte subsets and tumor markers were compared among the patients with different syndrome elements. Results: The data of 79 patients were collected. The syndrome elements with frequency more than 10% were selected for analysis, including disease nature syndrome elements(such as qi deficiency, phlegm turbidity, yin deficiency, blood stasis, heat, yang deficiency and dryness) and disease site syndrome elements(such as lung, kidney, spleen and heart). ①In the aspect of disease nature syndrome elements, there were no statistically significant differences on the levels of CD3+, CD4+ and CD8+ T lymphocytes among the patients with different syndrome elements(P>0.05);in the aspect of disease site syndrome elements, there were no statistically significant differences on the levels of CD3+, CD4+ and CD8+ T lymphocytes among the patients with different syndrome elements(P>0.05). ②In the aspect of disease nature syndrome elements, compared with the patients with yang deficiency syndrome element, the levels of CEA and CA125 in patients with qi deficiency,phlegm turbidity,yin deficiency,blood stasis,heat and dryness syndrome elements were decreased( P<0.05);in the aspect of disease site syndrome elements,there were no statistically significant differences on the levels of CEA,CA125,CA153 and CA199 among the patients with different syndrome elements( P>0.05). Conclusion: There is no obvious correlation between the Chinese medical syndrome elements and immune indexes in patients with IPF. There is certain correlation between yang deficiency syndrome element and tumor markers in patients with IPF,which may indicate the poor prognosis of the patients.