HBV宫内感染中医证型与Treg/TH17细胞因子平衡  

TCM syndrome types of HBV intrauterine infection and the balance of Treg/Th17 cytokines

作　　者：袁杰 崔玉 戴蕾 尹莹 车敏霞[1] YUAN Jie;CUI Yu;DAI Lei;YIN Ying;CHE Min-xia(Qingdao Hospital of Traditional Chinese Medicine(Qingdao Haici Hospital),Qingdao,Shandong 266000,China)

机构地区：[1]青岛市中医医院(青岛市海慈医院)产科,山东青岛266000

出　　处：《中华医院感染学杂志》2020年第23期3597-3601,共5页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(2019225)。

摘　　要：目的分析乙型肝炎病毒(HBV)宫内感染患者中医证型与调节性T淋巴细胞(Treg)/辅助性T淋巴细胞17(TH17)细胞因子平衡的相关性。方法选取青岛市中医医院HBV感染孕妇360例,依据HBV感染情况分为宫内感染组(n=72)与对照组(无HBV宫内感染,n=288),对宫内感染组予以中医分型,分别纳入脾肾阳虚型组、肝肾阴虚型组、肝郁脾虚型组、瘀血阻络型组与湿热中阻型组,比较宫内感染组不同中医证型亚组与对照组新生儿脐血、母体外周血Treg/TH17细胞因子[白细胞介素10(IL-10)、白细胞介素17(IL-17)]表达水平,并分析HBV宫内感染中医证型与IL-10、IL-17的关系。结果产妇与新生儿血清IL-17/IL-10为:对照组>肝郁脾虚型组>湿热中阻型组>瘀血阻络型组>肝肾阴虚型组>脾肾阳虚型组(P<0.05);Logistic回归分析显示,产妇、新生儿IL-17/IL-10失衡为HBV宫内感染独立危险因素(P<0.05),产妇与新生儿IL-17/IL-10失衡与肝郁脾虚型、湿热中阻型、瘀血阻络型、肝肾阴虚型以及脾肾阳虚型HBV宫内感染发生有关(P<0.05)。结论 HBV宫内感染产妇以及新生儿均存在IL-10、IL-17表达增强现象,脾肾阳虚型者IL-17/IL-10失衡情况最严重,IL-17/IL-10失衡属于HBV宫内感染独立危险因素,且与各种中医证型HBV宫内感染发生密切相关。OBJECTIVE To analyze the correlation between TCM syndrome types of hepatitis B virus(HBV) intrauterine infection and the balance of regulatory T lymphocyte(Treg)/helper T lymphocyte 17(TH17) cytokines. METHODS Total of 360 pregnant women in the hospital were recruited and divided into the intrauterine infection group(72 cases) and the control group(288 cases) according to whether they got HBV infection. According to the TCM type, patients in the intrauterine infection group were divided into the spleen-kidney yang deficiency group, liver-kidney yin deficiency group, liver depression and spleen deficiency group, blood stasis obstructing the collaterals group and damp-heat mid-retention group. Expression levels of Treg/TH17 cytokines such as interleukin 10(IL-10) and interleukin 17(IL-17)] in neonatal cord blood and maternal peripheral blood were compared between the intrauterine infection group and control group, and among subgroups of the intrauterine infection group. The relationship between TCM syndrome types of HBV intrauterine infection and IL-10, IL-17 was analyzed. RESULTS The ratio of serum IL-17/IL-10 in parturient and neonate of different groups were control group > the liver depression and spleen deficiency group > the damp-heat mid-retention group > the blood stasis obstructing the collaterals group > the liver-kidney yin deficiency group > the spleen-kidney yang deficiency group(P<0.05). Logistic regression analysis showed that IL-17/IL-10 imbalance in parturient and neonate was an independent risk factor for HBV intrauterine infection(P<0.05). Maternal and neonatal IL-17/IL-10 imbalance was related to liver depression and spleen deficiency type, damp-heat mid-retention type, blood stasis obstructing the collaterals type, liver-kidney yin deficiency type and spleen-kidney yang deficiency type HBV intrauterine infection(P<0.05). CONCLUSION Expression levels of IL-10 and IL-17 were increased in both pregnant women with HBV intrauterine infection and their neonates. Imbalance of IL-17/IL-10 is the most s

关 键 词：乙型肝炎病毒 宫内感染 中医证型 TREG细胞 TH17细胞 

分 类 号：R512.6+2[医药卫生—内科学]