脓毒症患者不同中医证型T淋巴细胞亚群及活化淋巴细胞的变化  

Changes of T Lymphocyte Subsets and Activated Lymphocytes in Septic Patients with Different TCM Syndromes

作　　者：蔡国龙[1] 杨敏春[2] 严静[1] 陈进[1] 许强宏[1] 颜默磊[1] 余海燕[1] 吕晓春[1] 胡才宝[1] 

机构地区：[1]浙江医院重症医学科,浙江杭州310013 [2]浙江医院中医科,浙江浙江310013

出　　处：《中华中医药学刊》2013年第8期1608-1610,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：卫生部公益行业基金资助项目(201202011);浙江省中医药管理局重点科研资助项目(2009ZA011;2011ZZ001);卫生部-浙江省医药卫生共建基金资助项目(wkj2012-2-020)

摘　　要：目的:探讨脓毒症患者T淋巴细胞亚群百分比及活化淋巴细胞HLA-DR水平在不同中医证型的变化及临床意义。方法:将68例脓毒症患者辨证分为气分组23例、营分组28例、血分组17例,另设对照组26例,运用流式细胞仪分别检测参数T淋巴细胞亚群CD3+、CD3+CD4+、CD3+CD8+百分比,活化淋巴细胞CD3+HLA-DR+、CD4+HLA-DR+、CD8+HLA-DR+水平,计算得CD3+CD4+/CD3+CD8+。结果:与对照组比较,气分营分血分证的所有检测参数均有显著性差异(P<0.05);与气分组比较,营分血分证CD3+、CD3+CD8+、CD3+CD4+/CD3+CD8+、CD3+HLA-DR+、CD8+HLA-DR+存在显著性差异(P<0.05);与营分比较,血分证CD3+、CD3+CD4+、CD3+CD8+、CD3+HLA-DR+、CD4+HLA-DR+、CD8+HLA-DR+存在显著性差异(P<0.05),而CD3+CD4+/CD3+CD8+无显著差异外(P>0.05)。结论:脓毒症患者T淋巴细胞亚群百分比及活化淋巴细胞水平的表达随着中医证型的变化而不同。动态观察这些参数可作为脓毒症辨证的相关参考指标。Objective ： To study the level and significance of T lymphocyte subsets and activated lymphocytes in periph- eral blood of patients with sepsis in different TCM syndromes. Methods ： Blood samples were consecutively collected from 26 non - septic control patients and 68 septic patients. By TCM syndrome differentiation, the septic patients were divided intoQi-fen group （n =23）, Yin-fen group （u =28） and Xue-fen group （n =17）. The expressions of CD3, CD3＋ CD4＊, CD CDs＋ cells and CD[ HLA - DR ＋ , CD4＋ HLA - DR ＋ , CDs HLA - DR of 68 septic patients were detec- ted by flow cytometry ; and white blood cell （ WBC ） counts were measured. Twenty - six healthy individuals served as controls. Results ： In comparison with control, there was a significant difference in all the above parameters （ all P 〈 0. 05 ） . In septic patients, Ying - Fen and Xue - Fen groups have significantly changes on the level of CD3＋ , CD3＋ CDs , CD3＋ CD4/ CD3 CDs ,CD; HLA - DR＋ and CDs＋ HLA - DR＋ compared to those in Qi -fen group （P 〈0. 05） ;Xue - Fen group had significantly changes on the levels of CD3＋ , CD[ CD8＋ , CD3＋ HLA - DR arid CDs HLA - DR ＋ compared to those in Ying - Fen group （ P 〈 O. 05） except for CD3＋ CD{ / CD CDs （P 〉 O. 05）. Collusion ： Serum T lymphocyte subsets and activated lymphocytes level altered in patients with different TCM syndromes. Dynamic observation of T lym- phocyte subsets and activated lymphocytes could contribute to the TCM syndrome differentiation for sepsis.

关 键 词：脓毒症 中医辨证 淋巴细胞 免疫功能 

分 类 号：R222.19[医药卫生—中医基础理论]