银屑病血热及血瘀证患者外周血Th1/Th2细胞表达差异研究

目的探讨银屑病血热及血瘀证的发病与外周血I型T辅助细胞（T helper cell 1，Th1）／Ⅱ型T辅助细胞（Thelper cell2，Th2）细胞轴漂移的相关性，观察血热及血瘀证银屑病患者与健康人外周血Th1/Th2细胞表达的差异。方法银屑病患者血热证组及血瘀证组各15例，健康对照组16例，采用流式细胞仪（flowcytome-try，FACS）检测单个核细胞（theperipheralbloodmononuclearcells，PBMCs）中CD4＋T细胞内细胞因子γ-干扰素（1-interferon，IFN-γ）、白介素-4（jnterleukin．4，IL-4）的表达情况；ELISA法检测不同证候银屑病患者血清中Thl型主要细胞因子IFN-γ和Th2型主要细胞因子IL-4的水平，并进行银屑病皮损面积和严重程度指数（the Psoriasis Areaand Severity Indexscore，PASI）评分。结果FACS结果示：血热证组外周血PBMCs中CD4＋IFN-γ水平显著高于血瘀证组及健康对照组（P〈0．05），且与PASI评分呈正相关（P〈0．05）。ELISA结果示：血热证组外周血清中IFN-γ水平显著高于血瘀证组及健康对照组（P〈0．05），血热证组血浆中IFN．叫水平与PASI评分呈正相关（P〈0．05），血瘀证组血浆中IFN-γ水平与PAS1评分呈负相关（P〈0．05）。血热证组外周血清中IL-4水平显著低于血瘀证组及健康对照组（P〈0．05）。结论外周血Th1细胞在血热型银屑病的发病中占主导地位，当血热型银屑病向血瘀型转化或正常转归时，外周血Th1细胞的表达下降。

Research on Different Expressions of Peripheral Blood Thl/Th2 Cells in Psoriasis Patients of Blood Heat Syndrome and of Blood Stasis Syndrome

Objective To explore the correlation between the pathogenesis of psoriasis patients of blood heat syndrome （BHS） and blood stasis syndrome （BSS） and peripheral blood Thl /Th2 cells axis drift, and to observe different expressions of peripheral blood Th1/Th2 cells between healthy subjects and psoriasis patients of BHS and BSS. Methods There were 15 patients in the BHS group and 15 in the BSS group. There were 16 patients in the healthy control group. The expressions of CD4 -interferon （IFN-γ） and interleukin-4 （IL-4） in the peripheral blood mononuclear cells （PBMCs） were measured by flow cytom- etry （FACS）. The Thl main cytokines such as IFN-γ and Th2 cytokines such as IL-4 in the serum of psoria- sis patients of different syndromes were detected by enzyme-linked immunosorbent assay （ELISA）. The Psoriasis Area and Severity Index score （PASI） were conducted. Results FACS results showed that the expression level of CD4＋ IFN-γ in the PBMCs was significantly higher in the BHS group than in the BSS group and the healthy control group （P 〈0.05）. Besides, it was positively correlated with the PASI （P 〈 0.05）. ELISA results showed that the peripheral serum level of IFN-γ was significantly higher in the BHS group than in the BSS group and the healthy control group （P 〈0.05）. The plasma level of IFN-γ was posi- tively correlated with the PASI score in the BHS group （P 〈0.05）. The plasma level of IFN-γ was negatively correlated with the PASI score in the BSS group （P 〈0.05）. The peripheral serum level of IL-4 was signifi- cantly lower in the BHS group than in the BSS group and the healthy control group （P 〈0.05）. Conclusions Peripheral ＂l-h1 cells had dominant state in psoriasis patients of BHS. When psoriasis patients of BHS were transformed to BSS or to the normal level, the expression of peripheral blood Thl cells decreased.