【摘要】 目的:应用蛋白芯片技术探究HBV导致的慢性肝病患者血清IL-2、IFN-γ、IL-4、TNF-α、sICAM-1、TGF-β1、TIMP-1等细胞因子与中医证型的相关性。方法:构建细胞因子蛋白芯片,对健康人群、不同中医证型的慢性乙型肝炎和乙型肝炎肝硬化患者血清中7种细胞因子进行检测。结果:①慢性乙型肝炎患者各证型IL-2水平较正常组不同程度降低;湿热中阻型患者IL-4浓度为(86·43±19·24)pg/ml,与正常组比较差异无显著性意义,其余证型患者IL-4水平均显著升高;各证型组患者的TNF-α、TGF-β1、sICAM-1、TIMP-1均较正常组显著升高(P<0·01),以湿热中阻型患者的TNF-α上升幅度最大,TGF-β1、sICAM-1及TIMP-1则以瘀血阻络型患者的升高最明显;肝郁脾虚及湿热中阻型患者血清IFN-γ与正常组比较,差异无显著性意义,而另外3种证型患者血清IFN-γ水平均显著低于正常组。②肝硬化除湿热内蕴型患者血清IFN-γ与正常组比较差异无显著性意义外,其余各证型患者血清7种细胞因子与正常组比较,差异均有显著性意义;脾虚湿盛、脾肾阳虚、血瘀证3型患者的IL-2水平显著低于肝气郁结型,而IL-4、TNF-α水平较肝气郁结型不同程度升高;TGF-β1、sICAM-1在湿热内蕴型水平最低;肝气郁结型患者的TIMP-1浓度为(167·88±14·21)ng/ml,与其他证型比较,差异均有显著性意义;湿热内蕴型患者IFN-γ浓度与肝气郁结型比较,差异无显著性意义,而其余证型均低于肝气郁结型。结论:慢性乙型肝炎、乙型肝炎肝硬化患者不同中医证型与血清细胞因子有一定相关性,将细胞因子纳入HBV所致慢性肝病患者中医辨证论治体系,有利于提高中医辨证的精确性和规范性。更多还原

【Abstract】 Objective:To study the relativity between Chinese medicine syndrome types and cytokine in chronic HBV hepatopathy patient serum with protein chip technology,including IL-2、IFN-γ、IL-4、TNF-α、sICAM-1、TGF-β1、TIMP-1.Methods:Cytokine protein chip detection system was designed and used to analyze 7 cytokines in different kinds of patients,inciluding healthy controls,chronic HBV hepatitis and liver cirrhosis of different Chinese medicine syndrome types.Results:①Compared with the normal group the content of IL-2 was notable lower;the content of IL-4 was 86.43±19.24pg/ml in damp-heat endogenous retention type,there was no difference between damp-heat endogenous retention type and the normal group,the content in other types was notable higher;the content of TNF-α,TGF-β1,sICAM-1 and TIMP-1 in different types was higher compared with the normal group,the content of TNF-α in damp-heat endogenous retention type was maximum;the content of TGF-β1,sICAM-1 and TIMP-1 increased significantly in blood stagnation endogenous retention type;the content of IFN-γ in stagnation of liver Qi and spleen deficiency type,damp-heat endogenous retention type and the normal group were similar,while the content in other three groups were notable lower than the normal group.②The content of IFN-γ in damp-heat endogenous retention type of patients with HBV-liver cirrhosis was 62.68±8.56pg/ml,which was similar with the normal group,but different from other types;IL-2 in damp abundance due to splenic asthenia type,deficiency of spleen and kidney Yang type and blood stagnation type were lower significantly than stagnation of liver Qi type;TGF-β1 and sICAM-1 were minimum in damp-heat endogenous retention type;TIMP-1 in stagnation of liver Qi type was minimum;IFN-γ in all types were lower than stagnation of liver Qi type(58.37±9.75pg/ml) except the damp-heat endogenous retention type.Conclusion:The different Chinese medicine syndrome types of chronic hepatitis B patient and patients with HBV-liver cirrhosis were relevant to serum cytokines,they could be considered to be new indexes to identity Chinese medicine syndrome types of patient with chronic HBV infection.更多还原