老年初治肺结核中医证型与细胞因子及免疫表达的相关性分析  

Correlation analysis between the traditional Chinese medicine certificate type of the old treatment of tuberculosis and cell multiflers and immune expression

作　　者：李玲[1] 王涛[1] 梁建琴[1] 丁红[2] Li Ling;Wang Tao;Liang Jianqin;Ding Hong(Department of Tuberculosis Medical,the Eighth Medical Center of Chinese PLA General Hospital,Beijing 100091,China;Consortium Office,the Eighth Medical Center of Chinese PLA General Hospital,Beijing 100091,China)

机构地区：[1]解放军总医院第八医学中心结核医学部,北京100091 [2]解放军总医院第八医学中心医联体办公室,北京100091

出　　处：《中国医刊》2024年第5期505-508,共4页Chinese Journal of Medicine

基　　金：“十三五”艾滋病和病毒性肝炎等重大传染病防治国家科技重大专项(2018ZX10722-301-005)。

摘　　要：目的 观察老年初治肺结核患者血清中细胞因子及TB淋巴细胞亚群的表达水平,探究中医证型与细胞因子、TB淋巴细胞表达之间的关系。方法 纳入2016年5月至2021年12月解放军总医院第八医学中心结核医学部收治的初治老年肺结核病患者322例作为研究对象,根据辨证分型分为肺阴亏虚组78例、阴虚火旺组83例、气阴两虚组79例、阴阳两虚组82例。采用酶联免疫吸附试验检测血清中γ干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、IL-5、IL-2、IL-6、IL-8、IL-17、IL-4、IL-10等细胞因子的表达水平,流式细胞仪测定TB淋巴细胞亚群中CD3^(+)、CD4^(+)、CD8^(+)、B细胞、NK细胞的绝对数及CD4^(+)/CD8^(+)T细胞比值,并将测定结果进行统计学分析。结果 四组肺结核患者IL-β、IL-5、IL-2、IL-17、IL-4、IL-10水平差异无统计学意义(P>0.05)。气阴两虚组IFN-γ水平显著高于其他三组(P<0.05);阴阳两虚组TNF-α水平显著高于其他三组(P<0.05);阴阳两虚组、气阴两虚组、阴虚火旺组、肺阴亏虚组的IL-6水平依次降低(P<0.05);阴阳两虚组IL-8水平显著高于其他三组,气阴两虚组高于肺阴亏虚组、阴虚火旺组(P<0.05)。CD3^(+)、CD4^(+)、CD8^(+)、B细胞、NK细胞绝对数在阴阳两虚组、气阴两虚组、阴虚火旺组、肺阴亏虚组依次降低,差异均有统计学意义(P<0.05)。阴阳两虚组CD4^(+)/CD8^(+)T细胞比值显著高于其他三组,肺阴亏虚组、阴虚火旺组、气阴两虚组组间比较差异无统计学意义(P>0.05)。结论 不同证型的老年肺结核病患者细胞因子及免疫细胞表达存在差异性,可作为中医辨证论治的客观参考标准之一,为临床辨证治疗提供一定参考。Objective The expression level of cytokines and TB lymphocyte subsets in the serum of elderly patients with pulmonary tuberculosis was studied,and the relationship between TCM syndrome and cytokine and TB lymphocyte expression was explored.Method A total of 322 elderly patients with pulmonary tuberculosis who were finally diagnosed with pulmonary tuberculosis from May 2016 to December 2021 due to treatment at the Eighth Medical Center of the Chinese PLA General Hospital were collected,and were divided into four groups according to dialectical classification:lung yin deficiency,yin deficiency and fire prosperity,qi and yin deficiency,and yin and yang deficiency.The expression levels of human interferon-γ(IFN-γ),tumor necrosis factor α(TNF-α),interleukin-β(IL-β),IL-5,IL-2,IL-6,IL-8,IL-17,IL-4and IL-10 were measured in serum by enzyme-linked immunosorbent assay.The absolute number of CD3~+,CD4~+,CD8~+,B cells,NK cells,CD4~+/CD8~+ in TB lymphocyte subsets were determined by flow cytometry.Result There was no significant difference in the expression levels of IL-β,IL-2,IL-17,IL-5,IL-4 and IL-10 among patients with different TCM syndrome types(P>0.05).The expression levels of IFN-γ,TNF-α,IL-6 and IL-8 were statistically significant(P<0.05) in the patients with different TCM syndrome types,and the expression level of IFN-γ in the qi and yin deficiency group was significantly higher than that in the other groups,and there was no significant difference between the two groups(P>0.05).There was no significant difference in the comparison between the two groups(P<0.05).The expression level of IL-6 in the yin and yang deficiency group,qi and yin deficiency group,yin deficiency and fire wang group,and lung yin deficiency group decreased in turn,and the difference was statistically significant(P<0.05).The expression levels of IL-8 was the highest in the yin and yang deficiency group,followed by the qi and yin deficiency group,and the expression level was higher than that in the lung yin deficiency group,yin deficiency

关 键 词：老年肺结核 中医证型 细胞因子 淋巴细胞亚群 辨证论治 

分 类 号：R521[医药卫生—内科学]