不同中医证型肺结核患者外周血Th17/Treg表达及其与病情的关系  

Expression of Th17/Treg in peripheral blood of pulmonary tuberculosis patients with different traditional Chinese medicine syndrome types and its correlation with their condition

作　　者：葛舰 苏红 赵蕾 任方元 彭杨 王祖君 GE Jian;SU Hong;ZHAO Lei(The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,China)

机构地区：[1]恩施土家族苗族自治州中心医院感染科,湖北恩施445000

出　　处：《四川中医》2025年第3期155-158,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：湖北省卫健委面上项目(编号:ZY2021M083)。

摘　　要：目的:探讨肺结核不同证型患者外周辅助性T细胞17(Th17)、调节性T细胞(Treg)及其主要效应因子白介素-17(IL-17)、白介素-10(IL-10)的表达特点及其与病情的关系。方法:将2021年1月~2022年12月在恩施州中心医院感染科就诊的78例初治肺结核患者,按中医证型不同分为肺阴亏虚组、阴虚火旺组、阴阳两虚组,流式细胞术检测患者外周血单个核细胞中Th17、Treg细胞占比,及相关主要效应因子IL-17、IL-10的表达,比较不同证型肺结核患者Th17、Treg、Th17/Treg、IL-17、IL-10的表达水平,分析其与病情的相关性。结果:肺阴亏虚组、阴虚火旺组、阴阳两虚组患者Th17细胞占比依次下降(P<0.05),Treg细胞占比肺阴亏虚组最高,阴虚火旺组与阴阳两虚组相近(P<0.05),Th17/Treg比值依次升高(P>0.05)。三组患者IL-17、IL-10的表达水平不存在差异。重症肺结核患Th17细胞低于非重症患者,Treg细胞高于非重症患者。结论:肺结核患者随着肺阴虚情况加重,Th17、Treg细胞占比逐步下降,Th17/Treg失衡越严重,Th17细胞下降,Treg细胞升高与肺结核病情相关,可为肺结核临床辨证治疗提供依据。Objective: To explore the expression characteristics of peripheral helper T cells 17(Th17),regulatory T cells (Treg),and their main effector factors interleukin-17(IL-17) and interleukin-10(IL-10) in patients with different syndrome types of pulmonary tuberculosis,and their relationship with the disease condition. Methods: 78newly treated pulmonary tuberculosis patients who visited the Department of Infectious Diseases at Enshi Central Hospital from January 2021to December 2022were divided into three groups based on different TCM syndromes: lung yin deficiency group,yin deficiency fire excess group,and yin yang deficiency group. Flow cytometry was used to detect the proportion of Th17and Treg cells in peripheral blood mononuclear cells,as well as the expression of the main effector factors IL-17and IL-10. The expression levels of Th17,Treg,Th17/Treg,IL-17,and IL-10in pulmonary tuberculosis patients with different syndrome types were compared,and their correlation with the disease was analyzed. Results: The proportion of Th17cells in the lung yin deficiency group,yin deficiency fire excess group,and yin yang deficiency group decreased sequentially ( P <0.05),while the proportion of Treg cells was the highest in the lung yin deficiency group. The yin deficiency fire excess group was similar to the yin yang deficiency group ( P <0.05),and the Th17/Treg ratio increased sequentially ( P >0.05). There was no difference in the expression levels of IL-17and IL-10among the three groups of patients. Th17cells in severe pulmonary tuberculosis patients are lower than those in non severe patients,and Treg cells are higher than those in non severe patients. Conclusion: With the aggravation of lung yin deficiency,the proportion of Th17and Treg cells in pulmonary tuberculosis patients gradually decreases. The more serious the imbalance of Th17/Treg,the lower the Th17cells. The increase of Treg cells is related to the condition of pulmonary tuberculosis,which can provide a basis for clinical dialectical treatment of pulmonary tub

关 键 词：TH17 TREG 肺结核 证型 

分 类 号：R256.1[医药卫生—中医内科学]