急性胰腺炎各证型T淋巴细胞亚群的变化与意义

目的:探究急性胰腺炎中医辨证分型患者外周静脉血中T淋巴细胞亚群CD3、CD4、CD8及CD4+/CD8+值的变化,探讨这些变化在急性胰腺炎中医辨证分型中的意义。方法:根据急性胰腺炎的中医证型标准随机抽取脾胃实热型、脾胃湿热型、肝郁气滞型、蛔虫上扰型4组,每组8人,共32人,检测4种证型外周血T细胞亚群水平,与对照组对比分析。结果 4种证型患者外周血T淋巴细胞亚群水平:①与对照组比较,脾胃湿热组CD3、CD8降低,CD4+/CD8+值升高,差异有显著性意义(P<0.05);脾胃实热组外周血CD3、CD8降低,CD4+/CD8+值升高,差异极显著(P<0.01),CD4明显降低,变化有显著性意义(P<0.05);肝郁气滞组,蛔虫上扰组值的变化无显著差异(P>0.05)。②与脾胃实热组比较,脾胃湿热组CD3、CD4、CD8及CD4+/CD8+值的升高变化有显著(P<0.05);肝郁气滞组与蛔虫上扰组的CD4+、CD4+/CD8+较之差异显著(P<0.05),CD3、CD8值的变化极显著(P<0.01)。结论:急性胰腺炎中医证型与T淋巴细胞亚群水平变化有关,CD3、CD8、CD4+/CD8+可作为AP中医临床辨证分型的参考指标。

Significance of T-Lymphocytes Change in Syndromes of Acute Pancreatitis

Objective：To explore the relationship between the changes of T- lymphocytes and the common TCM syndromes in population with acute panereatitis （AP） as well as the significance of these changes in dialectics. Methods：The changes of CD3 , CD4 and CDs of 8 normal persons and 32 acute pancreatitis patients＇peripheral blood were detected by flow cytometry. Results ： （ 1 ） The variety of T-lymphocytes in each syndromes compared to normal group were as following： CD3 and CD8 were decreased signifi- cantly while CD4 ＋/CD8 ＋ ratio increased in dampness-heat of spleen and stomach （P 〈 0. 05 ）and stomach-spleen heat of excess type groups（ P 〈 0. 01 ）. CD4 was down-regulated significantly in the latter（ P 〈 0. 05 ）. There was no change obviously in liver-qi stagnation and disturbance of Ascaris lumbricoides groups （ P 〉 0. 05 ）. （ 2 ） Compared to stomach-spleen heat of excess type groups,CD3 ,CD4, CD8 and CD4 ＋/CD8 ＋ ratio were higher in dampness-heat of spleen and stomach group（ P 〈 0. 05 ） and for liv- er-qi stagnation and disturbance of Ascaris lumbricoides groups,CD4 ＋ ,CD4 ＋/CD8 ＋ increased significantly（P 〈0. 05） and CD3 and CD8 increased remarkably （P 〈 0. 01 ）. Conclusion：T - lymphocytes are various based on this and CD3 , CD8 and CD4＋/CD8 ＋ may be the reference indexes in syndromes differentiation of AP.