慢性肝病患者外周血T细胞CD28表达与中医分型关系的探讨

Relationship between Syndrome Types of TCM and CD28 Expressed by T Lymphocyte in Patients with Chronic Liver Diseases

目的:探讨慢性乙型肝炎和肝硬化患者外周血T细胞亚群(即CD8^+、CD4^+细胞)CD28分子的表达与中医辨证分型的相互关系。方法:对门诊和住院的慢性乙型肝炎和肝硬化活动期患者82例、正常对照人群20例的外周血T淋巴细胞亚群CD28分子表达测定,结合中医辨证分析,从免疫学角度讨论两者相互关系。结果:所观察的CD28、CD4和CD4/CD8各数据组中,将慢性乙型肝炎和肝硬化活动期的中医辨证分型各组之值与正常对照组进行比较,经统计学处理,P>0.05;分型的各组总体差异,P<0.05或P<0.01;分型各组组间比较,P<0.05或P<0.01。慢性乙型肝炎、肝硬化中医分型各组的CD28表达水平与正常对照组相比,有显著差异;中医分型各组间亦有一定差异。从CD28^+CD8^+看,湿热中阻型明显升高,而其他3组与正常组相似;从CD28^+CD4^+看,肝郁脾虚型与湿热中阻型与正常组虽无明显差异,但其应答强弱顺序颇能说明问题,即肝肾阴虚组>肝郁脾虚和湿热中阻组>瘀血阻络组。结论:CD28表达可在慢性肝病中医辨证分型中发挥一定作用。

Objective: To explore the relationship between syndrome types of TCM and CD28 expressed by T lymphocyte in patients who have chronic hepatitis B or cirrhosis. Methods: 82 patients of chronic hepatitis B or cirrhosis were classified, according to syndrome differentiation of TCM into four groups: damp blockage of middle Jiao group, hepatic stagnation causing splenic deficiency group, hepatic and renal yin deficiency group, blood stasis and collaterals stagnation group. Their CD28 expressed by T lymphocyte were detected, and compared with 20 cases health control group. Results: damp blockage of middle Jiao group's CD28 expressed by CD8+ T lymphocyte was higher than in control group, but there was no statistical difference between other group and control group. Four group's CD28 expressed by CD4+ T lymphocyte were no statistical difference, but the level of CD28 in turn hepatic and renal yin deficiency group>damp blockage of middle Jiao group and hepatic stagnation causing splenic deficiency group> blood stasis and collaterals stagnation group. Conclusions: CD28 can play a role in classifying syndrome types of TCM.