慢性乙型病毒性肝炎中医证型与肝组织淋巴细胞亚群分布及HBcAg表达的关系  

The association of hepatic lymphocyte subsets and the expression of HBcAg in the liver tissue with different syndrome types of chronic hepatitis B patients

作　　者：郑启忠 毛乾国 张玉凤 唐金模 Zheng Qizhong

机构地区：[1]福建中医药大学附属厦门中医院

出　　处：《中医临床研究》2019年第10期1-5,共5页Clinical Journal Of Chinese Medicine

基　　金：厦门市科技局惠民项目,慢性乙型病毒性肝炎中医证型与肝组织淋巴细胞亚群分布及HBcAg表达的关系(项目编号:3502Z20144029)

摘　　要：目的:观察慢性乙型病毒性肝炎不同中医证型肝组织乙型肝炎核心抗原(Hepatitis Bcore Antigen,HBcAg)及淋巴细胞亚群表达的情况,为慢性乙型病毒性肝炎中医辨证论治提供客观依据。方法:通过观察慢性乙型病毒性肝炎(Chronic HepatitisB,CHB)中医证型组间肝组织免疫效应细胞CD4^+T细胞、CD8^+T细胞分布及肝组织HBcAg表达情况,并与肝组织炎症活动度(G)、血清谷丙转氨酶(Alanine Transaminase,ALT)、乙肝病毒的脱氧核糖核酸(HBV-DNA)定量组成多变量,运用多分类Logistic回归法分析并探究CHB6种证型的独立影响因素。结果:6种中医证型一般资料(年龄分布、性别)、血清ALT及HBV-DNA载荷均存在较大的差别(P<0.05),在所研究的6种证型中HBV-DNA的含量远远高于正常值(P<0.05),肝组织HBcAg阳性是肝肾阴虚证除外其余五种证型的独立影响因素;湿热蕴结证、肝郁气滞证、瘀血阻络证受肝组织CD4^+T细胞、CD8^+T细胞数变化的独立影响。结论:CHB各中医证型免疫功能状态强度与肝组织炎症活动度、肝组织HBcAg免疫组化阳性程度、CD4^+T细胞、CD8^+T细胞量直接相关。Objective:To observe the expression of HBcAg and lymphocyte in liver of different TCM syndromes of chronic hepatitis B (CHB),and to provide objective evidence for the treatment of CHB with TCM syndrome differentiation.Methods:Distribution of CD4^+ T and CD8^+ T in liver tissue and liver tissue HBcAg expression in the CHB TCM syndrome group were observed,and those with liver tissue inflammation activity (G),serum ALT,HBV-DNA quantification composed multivariate.The independent influencing factors of the six types of CHB syndrome were analyzed by multi-class logistic regression.Results:There were significant differences amon the six types of TCM syndrome types (age,gender),serum ALT and HBV-DNA load (P<0.05).Among them,the content of HBV-DNA was higher than normal (P<0.05).HBcAg positive in liver tissue is an independent influencing factor only the Ganshen Yinxu syndrome (肝肾阴虚证).The Shire Yunjie syndrome (湿热蕴结证),the Ganyu Qizhi syndrome (肝郁气滞证) and the Yuxue Zuluo syndrome (瘀血阻络证) were independently affected by changes in the number of CD4^+ T cells and CD8^+ T cells in liver tissue.Conclusion:The immune function status of CHB with different TCM syndromes was correlated with liver tissue inflammation activity,positive degree of liver tissue HBcAg immunohistochemistry,the amount of CD4^+ T cells and CD8^+T cells.

关 键 词：慢性乙型病毒性肝炎 中医证型 免疫功能状态 T淋巴细胞亚群 乙肝核心抗原 病理 免疫组化 

分 类 号：R512.62[医药卫生—内科学]