临床医学论文•慢性乙型肝炎不同脾虚兼证与外周血树突状细胞表型及功能的关系作者：王磊，冯晓霞，张玮，邢练军，郑培永，季光【摘要】目的：硏究慢性乙型肝炎(chTonichepatitisB,CHB)患者不同脾虚兼证与外周血树突状细胞(dendriticcell,DC)表型及功能的关系°方法:CHB患者60例，按中医证候诊断标准分为脾虚肝郁、脾虚湿热和脾肾两虚组，每组20例，10名健康人为正常对照。分离各组外周血单个核细胞，体外诱导培养DC，流式细胞仪测定DC表型，酶联免疫吸附检测法测定DC分泌白细胞介素10(interleukin10,IL10)浓度，同步检测患者生化指标及乙肝病毒的脫氧核糖核酸(hcpnliUsBvirusDNA,HBVDNA)水平。结果：CHB患者DC体外诱导增殖能力较正常人下降,DC成熟表面标记物显著低于正常人(P<0.05)。不同证候CHB患者DC表面标记物CD80、CD86和CDla表达阳性率均低于正常人(P<0.05)。脾虚肝郁证患者CD80、CDM和HLADR表达阳性率显著高于脾肾两虚证(P<0・05)，脾虚湿热证患者CDM表达阳性率显著高于脾肾两虚证(P<0.05)。CHB患者DC培养上清中IL10浓度显著高于正常人(P<0.05)。脾肾两虚证患者DC培养上清中IL10含量高于脾虚肝郁证(P<0・05)。结论：在CHB发病过程中，不同脾虚兼证CHB患者DC的表型及功能间存在差异，提示中医证候分类与机体免疫功能之间存在一定相关性。【关键词】慢性乙型肝炎；树突状细胞；中医学；脾虚；证候---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---Objective:Tostudythephenotypesandfunctionsofdendriticcells(DCs)derivedfromperipheralbloodmonocytesofchronichepatitisB(CHB)patientswithdifferenttraditionalChinesemedicine(TCM)syndrometypes,andtoexploretherelationshipbetweenTCMsyndrometypeandDCfunctions.Methods:SixtyCHBpatientswereincludedinthisstudy.Al1theCHBpatientsweredividedintospleendeficiencyandliverstagnation,spleendeficiencyanddampnessheatanddeficiencyofbothspleenandkidneygroupsaccordingtoTCMsyndromediagnosisstandard・Therewere20casesineachgroup,andtenhealthypeoplewereincludedasnormalcontro1.Thevoluntccr，speripheralbloodwascollectedformonocyteseparation,biochemicaltestandhepatitisBvirusDNAloadsdetection.DCswereinducedandisolatedfromperipheralbloodmonocytes,andthentheexpressionsofsurfacemarkersCD80,CD86,CDlaandHLADRweredetectedbyflowcytometricanalysismethod.InlcTlcukin10(IL10)productionoftheDCswasquantificdbyenzyme1inkedimmunosorbentassay.Results:TheproliferationofDCsintheCHBpatientswass1owerthanthatinthehealthyvolunteers(P<0.05)・TheexpressionsofDCsurfacemoleculessuchasCD80,CD86,andCDlawereobviouslydecreasedintheCHBpatientsascomparedwiththoseinthehealthyvolunteers(Pv0・05)・Moreover,expressionsofDCsurfacemoleculesweredifferentamongCHBpatientswithdifferentTCMsyndrometypes.ThepositivcexpressionsofCD80,CDla,andHLADRintheCHBpatientswithspleendeficiencyandliverstagnationwereobviouslyhigherthanthoseintheCHBpatientswithdeficiencyofbothspleenandkidney(P<0・05),andtheCDlaexpressionintheCHBpatientswithspleendeficiencyanddampnesshealwashigherthanthatintheCHBpatientswithdeficiencyofbothspleenandkidney(P<0.05).InDCculsupernatant,theTL10concentrationoftheCHBpatientswithdeficiencyofbothspleenandkidneywashigherthanthatoftheCHBpatientswithspleendeficiencyand1iverstagnation(PvO.O---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---5),andtheIL10concentrationsoftheCHBpatientswithdifferentTCMsyndrometypeswerehigherthanthatofthehealthyvolunteers(Pv0・05)・Conclusion:DuringthepathogeniccourseofCHB,thephenotypesandfunctionsofDCsaredifferentinCHBpatientswithdifferentTCMsyndrometypes.ItsuggeststhatthereisacorrelationbetweenTCMsyndrometypeandbodyim...