“肺卫失宣”与相关细胞因子关系的临床研究

Clinical Study on the Correlation of Lung-Wei Sluggishness Pathogenesis with the Serum Levels of Associated Cytokines

目的探讨肺卫失宣与白细胞介素 —1 β(interleukin—1 ,IL—1 β)、白细胞介素—6(interleukin—6,IL—6)、白细胞介素 —1 0 (interleukin—1 0 ,IL—1 0 )、肿瘤坏死因子 —α(tumornecrosisfactor—α,TNF—α)、γ— 干扰素 (interferon—γ,IFN—γ)等细胞因子 (cytokine,CK)的关系。方法采用酶联免疫吸附法检测 2 4例温病卫分证患者及 2 6例气分证患者血清中上述CK的水平 ,观察不同病位、不同病程阶段卫分证、气分证血清各指标水平变化。结果①卫分证IL—1 β、IL—6水平升高 (P <0 .0 1或P <0 .0 5 ) ;②气分证IL—6、IL—1 0较卫分证明显升高 (P <0 .0 1或P <0 .0 5 ) ,IL—1 β、TNF—α在以肺为病变中心时升高 (P <0 .0 5 ,P <0 .0 1 ) ;③以肺为病变中心的IL—1 β水平高于非肺为病变中心 (P <0 .0 5或P <0 .0 1 ) ,IL—6相反 (P <0 .0 5 ) ;同证不同病位间的TNF—α、IL—1 0水平差异无显著性 (P >0 .0 5 ) ;④卫分证热退后IL—1 β下降 (P <0 .0 1 ) ;气分证热退后 ,IL—1 0下降 (P <0 .0 5或P <0 .0 1 ) ,非肺为病变中心的卫分证及气分证热退后 ,IL—6水平下降 (P <0 .0 1 ) ,TNF—α热退前后差异无显著性(P >0 .0 5 ) ;⑤所有卫分证、气分证及健康对照组血清中均未检测到IFN—γ。

Objective To investigate the correlation of Lung Wei sluggishness pathogenesis(LWSP) with the serum levels of associated cytokines(CKs). Mothods The serum levels of associated CKs were determined by enzyme linked immuno sorbent assay(ELISA) among 24 cases with Weifen pattern and 26 cases with Qifen pattern. Then, analyzed were the changes of CK levels in serum and their implications in the pathogenesis of these two patterns. Results Firstly, the levels of IL 1β and IL 6 were elevated in Weifen pattern ( P <0.01～0.05).Secondly, the levels of IL 6 and IL 10 were significantly higher in Qifen pattern ( P <0.01～0.05) than in Weifen pattern.Meanwhile,the increase of IL 1β and TNF α was significant ( P <0.01～0.05) in the case of the Lung being the main focus and that of IL 6 was significant ( P <0.05) in the case of the main focus being out of the Lung, with no significant differences in the levels of TNF α and IL 10 found between the different foci among the cases with the same pattern ( P >0.05).Thirdly, the serum levels of CKs were decreased following fever subsided,mainly being IL 1β in Weifen pattern ( P < 0.01 ), IL 10 in Qifen pattern ( P <0.01～0.05)and IL 6 in Weifen pattern and Qifen one with the main foci out of the Lung( P < 0.01 ).Fourthly, TNF γ was negatively determined among all the cases,no matter which pattern it is or for healthy conctrolls.Conclusions The change of serum levels of IL 1β,IL 6, IL 10 and TNF α is associated with the pathogenesis of Weifen and Qifen patterns.Moreover, the levels of IL 1β and IL 6 are involved in the focus and stage of lesion and that of IL 10 and TNF α are possibly related with the stage of these patterns.