首页|肝胆湿热证与肝郁脾虚证慢性乙型肝炎患者血清细胞因子表达差异及特点研究

肝胆湿热证与肝郁脾虚证慢性乙型肝炎患者血清细胞因子表达差异及特点研究

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目的 研究肝胆湿热证和肝郁脾虚证的慢性乙型肝炎(CHB)患者血清白细胞介素(IL-6)、IL-10、IL-17、转化生长因子β1(TGF-β1)水平,探索不同证候之间的表达差异,同时探究CHB患者细胞因子在不同肝组织病理中的表达特点。方法 选取福建中医药大学附属厦门中医院2021年1月至2022年3月住院的CHB患者共138例为研究对象,检测所有患者的血清学指标和细胞因子水平,并同步进行经皮肝脏穿刺活检获取组织病理情况,对患者进行中医辨证分型,比较肝胆湿热证型和肝郁脾虚证型,不同炎症活动度、纤维化分期的CHB患者细胞因子表达差异。结果 IL-6及IL-17在肝胆湿热证患者中表达水平高于肝郁脾虚证,差异均有统计学意义(P=0。002、0。025),而IL-10及TGF-β1则在肝郁脾虚证患者中表达水平高于肝胆湿热证,差异均有统计学意义(P=0。001、0。005)。根据患者肝组织病理学结果显示,138例CHB患者中肝脏炎症活动度G1~G4分别有31、84、20、3例,肝胆湿热证与肝郁脾虚证CHB患者在炎症分布上比较,差异有统计学意义(P<0。05);而138例CHB患者中肝纤维化分期S1~S4分别有106、26、4、2例,CHB患者中肝胆湿热证和肝郁脾虚证在肝脏纤维化分期的分布比较,差异无统计学意义(P>0。05)。结论 CHB患者中肝胆湿热证和肝郁脾虚证之间细胞因子表达水平、炎症活动程度具有差异性,有助于识别肝胆湿热证和肝郁脾虚证,或可为临床评判病情和中医辨证分型提供个性化方法与治疗策略。
Difference and characteristics of serum cytokine expression in patients with chronic hepatitis B with hepatobiliary humid fever and hepatic depression and spleen deficiency syndrome
Objective To study serum interleukin(IL)-6,IL-10,IL-17 and transforming growth factor(TGF)-β1 levels in patients with chronic hepatitis B(CHB)with hepatobiliary humid fever and hepatic de-pression and spleen deficiency,to explore the expression differences between different syndromes,and to ex-plore the expression characteristics of cytokines in CHB patients in different liver tissues and pathologies.Methods A total of 138 CHB patients hospitalized in Xiamen Hospital of Traditional Chinese Medicine(TCM)Affiliated to Fujian University of Chinese Medicine from January 2021 to March 2022 were selected,serological indexes and cytokine levels of all the patients were detected,and percutaneous liver biopsy was per-formed simultaneously to obtain histopathological conditions and TCM differentiation classification was per-formed on the patients,and cytokine expression differences in CHB patients with different inflammatory activ-ity and fibrosis stages were compared with those with hepatobiliary humid fever and hepatic depression and spleen deficiency syndrome.Results The expression levels of IL-6 and IL-17 in patients with hepatobiliary humid fever syndrome were higher than those in patients with hepatic depression and spleen deficiency syn-drome(P=0.002,0.025),while the expression levels of IL-10 and TGF-β1 in patients with hepatic depres-sion and spleen deficiency were higher than those in patients with hepatobiliary humid fever syndrome(P=0.001,0.005).According to the results of liver histopathology,there were 31 cases,84 cases,20 cases and three cases of liver inflammatory activity G1-G4 in the 138 CHB patients,and the difference in inflammatory distribution between hepatobiliary humid fever and hepatic depression and spleen deficiency CHB patients was statistically significant(P<0.05).However,there were 106 cases,26 cases,four cases and two cases of liver fibrosis stage S1-S4 in the 138 CHB patients,and there was no significant difference in the distribution of hepatobiliary humid fever and hepatic depression and spleen deficiency in liver fibrosis stage in the CHB pa-tients(P>0.05).Conclusion There are differences in cytokine expression level and inflammatory activity between hepatobiliary humid fever and hepatic depression and spleen deficiency syndrome in CHB patients,which is helpful to identify hepatobiliary humid fever and hepatic depression and spleen deficiency syndrome,or can provide a method and treatment strategy for clinical evaluation of the disease and TCM differentiation classification.

Chronic hepatitis BSerum cytokineHepatobiliary humid feverHepatic depression and spleen deficiencyPathologyExpression difference

邹丹容、康燕能

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福建中医药大学,福建福州,350100

福建中医药大学附属厦门中医院,福建厦门,361000

厦门弘爱医院,福建厦门,361000

慢性乙型肝炎 血清细胞因子 肝胆湿热证 肝郁脾虚证 病理 表达差异

2024

现代医药卫生
重庆市卫生信息中心

现代医药卫生

影响因子:0.758
ISSN:1009-5519
年,卷(期):2024.40(5)
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