尋常型白癜風血清T細胞亞群、可溶性白介素-2受體、腫瘤壞死因子-α與中醫(yī)辨證的分析
發(fā)布時間：2018-10-16 19:51
【摘要】：研究目的： 1.以正常人為對照,觀測尋常型進展期白癜風患者外周血中CD3、CD4、CD8、CD4/CD8及sIL-2R、TNF-α水平,探討白癜風發(fā)病的細胞免疫機制。 2.分析白癜風中醫(yī)辨證分型與外周血T細胞亞群及sIL-2R、TNF-α水平的相關性,探討其中的規(guī)律性,有利于指導白癜風的臨床分型診治。 研究對象： 2011年6月至2012年3月期間至江蘇省中醫(yī)院皮膚科就診的白癜風初診患者,年齡在18-65周歲之間,共收集患者35例。診斷與分型分期依據《白癜風臨床分型及療效標準(2010年修訂稿)》。這些患者近3個月內未系統(tǒng)服用過糖皮質激素、免疫抑制劑及免疫調節(jié)劑,之前未確診過其他自身免疫性疾病。 方法： 1.試驗組：35例(男性20例,女性15例)年齡從18到58周歲(33.63±10.09歲)的尋常型進展期白癜風患者。對照組：20例(男性10例,女性10例)年齡從23到64周歲(35.26±11.12歲)的健康個體,沒有任何的自身免疫性疾病史。 2.采用統(tǒng)一設計的成人白癜風臨床調查表并對患者本人詢問,內容包括姓名、性別、年齡、病程、癥狀、體征、臨床分型、分期、舌苔、脈象等。 3.檢測方法：CD3、CD4、CD8采用流式細胞術檢測,sIL-2R及TNF-α采用酶聯免疫吸附法檢測。 4.統(tǒng)計學方法：Excel軟件建立數據庫,SPSS19.O軟件進行統(tǒng)計分析。統(tǒng)計采用獨立樣本t檢驗、秩和檢驗和X2檢驗,0.01P0.05為差異具有顯著的統(tǒng)計學意義,P0.01為差異具有非常顯著的統(tǒng)計學意義。 結果： 1.尋常型進展期白癜風患者的年齡構成在18-30歲,30-40歲,40-65歲之間未見差異,性別構成也無差異(P0.05)。 2.中醫(yī)證型的分布與尋常型進展期白癜風不同亞型、年齡組及性別的構成無明顯相關(P均0.05)。 3.與正常對照組相比較,尋常型進展期白癜風患者外周血CD3水平降低,有顯著差異(0.01P0.05)；外周血CD4水平降低,有非常顯著的差異(P0.01)；血CD8及CD4/CD8水平沒有明顯的統(tǒng)計學差異(P均0.05)。與正常對照相比,散在型進展期白癜風患者外周血CD3降低,有顯著差異(0.01P0.05)；CD4降低,有非常顯著的差異(P0.01)；CD8及CD4/CD8水平沒有顯著的統(tǒng)計學差異(P均0.05)。局限型進展期白癜風患者外周血CD3、CD4、CD8及CD4/CD8水平與正常對照組相比均沒有顯著的統(tǒng)計學差異(P均0.05)。 4.與正常對照組相比較,尋常型進展期白癜風患者組外周血sIL-2R水平升高,有非常顯著的統(tǒng)計學差異(P0.01)；外周血TNF-α水平升高,有顯著的統(tǒng)計學差異(0.01P0.05)。散在型患者組外周血sIL-2R及TNF-α水平與正常對照組比較均有非常顯著的統(tǒng)計學差異(P均0.01)。局限型患者外周血sIL-2R、TNF-α水平與對照組相比,均沒有顯著的統(tǒng)計學差異(P均0.05)。 5.肝腎陰虛證、氣滯血瘀證、濕熱蘊結證患者組之間CD3、CD4、CD8、CD4/CD8、sIL-2R、及TNF-α水平均無顯著統(tǒng)計學差異(P均0.05)。 結論： 1.本組尋常型進展期白癜風患者細胞免疫功能異常,主要表現為外周血CD3、CD4水平較正常對照組明顯降低,而CD8及CD4/CD8水平與對照組相比卻沒有統(tǒng)計學差異,外周血sIL-2R、TNF-α水平較正常對照組明顯增高。與正常對照組相比,散在型進展期白癜風患者外周血CD3、CD4水平明顯降低,sIL-2R、TNF-α水平明顯增高。而局限型與對照組相比卻沒有統(tǒng)計學差異。 2.尋常型進展期白癜風患者細胞免疫功能異常,提示了其發(fā)病與自身免疫有關,也進一步支持了白癜風的自身免疫發(fā)病學說。 3.白癜風各中醫(yī)證型間外周血CD3、CD4、CD8、CD4/CD8、sIL-2R及TNF-α水平均沒有明顯統(tǒng)計學差異,提示了中醫(yī)治療白癜風的辨證分型物質基礎是多方面的,與細胞免疫之間的關系需進一步探討。
[Abstract]:Purpose of the study: 1. To observe the levels of CD3, CD4, CD8, CD4/ CD8 and sIL-2R, TNF-and CD4/ CD8 and sIL-2R, TNF-and in peripheral blood of patients with vitiligo in normal control and observe the cellular immunity of vitiligo. 2. To analyze the correlation between TCM syndrome differentiation typing and peripheral blood T cell subpopulations and sIL-2R, TNF levels in patients with vitiligo. diagnosis and treatment of bed type Study object: From June 2011 to March 2012, the patients with vitiligo in the dermatological department of Chinese Hospital of Jiangsu Province, aged 18-65 years old A total of 35 patients were collected. The diagnosis and classification stage was based on the clinical classification of vitiligo and the standard of efficacy. (Revised 2010)>. None of these patients received corticosteroids, immunosuppressive agents and immunomodulators for nearly 3 months before Have a visit to it Method: 1. Test group: 35 cases (male 20 cases, female 15 cases) from 18 to 58 years old (33. 63) 10 Control group: 20 patients (10 males and 10 females) with age from 23 to 64 years old (35. 26 vs. 11. 12 years old) Kang individual, without any autoimmune disease history. 2. Adopt the unified design adult vitiligo clinical investigation questionnaire and ask the patient oneself, the content includes name, sex, age, course of course, Symptoms, signs, clinical classification, stage, tongue coating, tongue coating, etc. 3. Detection methods: CD3, CD4, CD8 were detected by flow cytometry. sIL-2R and TNF-1R were detected by enzyme-linked immunosorbent assay. 4. Statistical methods: Exc The statistical analysis of the database and SPSS19. O software was carried out by the el software. The independent sample t test, the rank sum test and the X2 test were adopted, and the difference between 0. 01P0. 05 was significant. Statistics The significance, P0. 01 were significant statistical significance for the difference. Results: 1. The age of patients with vitiligo in the normal progression period was 18-30 years, 30-There was no difference between 40 and 65 years of age, and there was no difference in gender composition (P0.05). There was no significant correlation between the different subtypes, age groups and sex (P <0.05). 3. Compared with the control group, the level of CD3 in peripheral blood of patients with vitiligo vulgaris was decreased significantly (P0.05), and the level of CD4 in peripheral blood was decreased, and there were very significant differences (P There was no significant difference in the levels of CD8 and CD4/ CD8 in patients with vitiligo (P <0.05). Compared with normal controls, the CD3 decreased in peripheral blood of patients with vitiligo, and there were significant differences (0. 01P0. 05); CD4 decreased, and there was very significant difference (P <0.05). There was no significant statistical difference between CD8 and CD4/ CD8 levels (P 0.05). CD3, CD4, CD in peripheral blood of patients with vitiligo Compared with the control group, the levels of sIL-2R in peripheral blood of patients with vitiligo vulgaris were significantly higher than those of normal control group (P <0.05). (P 0.01), the level of TNF-VEP in peripheral blood increased, and there were significant statistical differences (0. 01P0. 05). The levels of IL-2R and TNF-IL were significantly different from those of normal control group (P 0.01). Compared with the control group, there was no significant difference in serum sIL-2R and TNF level (P 0.05). CD8 There was no significant difference in the levels of CD4/ CD8, sIL-2R and TNF-tau (P <0.05). Conclusion: 1. The abnormal cellular immune function of patients with vitiligo vulgaris in this group is mainly characterized by peripheral blood CD3, CD4 water. Compared with the normal control group, the level of CD8 and C was significantly lower than that in the control group. Compared with the control group, the levels of sIL-2R and TNF levels in peripheral blood were significantly higher than those in the control group. Compared with the group, the peripheral blood C of patients with vitiligo in the stage of progressive vitiligo The levels of CD3 and CD4 decreased significantly, and the levels of sIL-2R and TNF-2R were significantly higher, but there was no statistical difference compared with the control group. The abnormal cellular immune function of vitiligo patients with ordinary progression suggested that the pathogenesis of vitiligo is related to autoimmune diseases, and it also supports the theory of autoimmune disease of vitiligo. The peripheral blood CD3, CD4, CD8, CD4/ CD8, sIL-2R and TNF in each TCM syndrome type of vitiligo.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R758.41
本文編號：2275460
[Abstract]:Purpose of the study: 1. To observe the levels of CD3, CD4, CD8, CD4/ CD8 and sIL-2R, TNF-and CD4/ CD8 and sIL-2R, TNF-and in peripheral blood of patients with vitiligo in normal control and observe the cellular immunity of vitiligo. 2. To analyze the correlation between TCM syndrome differentiation typing and peripheral blood T cell subpopulations and sIL-2R, TNF levels in patients with vitiligo. diagnosis and treatment of bed type Study object: From June 2011 to March 2012, the patients with vitiligo in the dermatological department of Chinese Hospital of Jiangsu Province, aged 18-65 years old A total of 35 patients were collected. The diagnosis and classification stage was based on the clinical classification of vitiligo and the standard of efficacy. (Revised 2010)>. None of these patients received corticosteroids, immunosuppressive agents and immunomodulators for nearly 3 months before Have a visit to it Method: 1. Test group: 35 cases (male 20 cases, female 15 cases) from 18 to 58 years old (33. 63) 10 Control group: 20 patients (10 males and 10 females) with age from 23 to 64 years old (35. 26 vs. 11. 12 years old) Kang individual, without any autoimmune disease history. 2. Adopt the unified design adult vitiligo clinical investigation questionnaire and ask the patient oneself, the content includes name, sex, age, course of course, Symptoms, signs, clinical classification, stage, tongue coating, tongue coating, etc. 3. Detection methods: CD3, CD4, CD8 were detected by flow cytometry. sIL-2R and TNF-1R were detected by enzyme-linked immunosorbent assay. 4. Statistical methods: Exc The statistical analysis of the database and SPSS19. O software was carried out by the el software. The independent sample t test, the rank sum test and the X2 test were adopted, and the difference between 0. 01P0. 05 was significant. Statistics The significance, P0. 01 were significant statistical significance for the difference. Results: 1. The age of patients with vitiligo in the normal progression period was 18-30 years, 30-There was no difference between 40 and 65 years of age, and there was no difference in gender composition (P0.05). There was no significant correlation between the different subtypes, age groups and sex (P <0.05). 3. Compared with the control group, the level of CD3 in peripheral blood of patients with vitiligo vulgaris was decreased significantly (P0.05), and the level of CD4 in peripheral blood was decreased, and there were very significant differences (P There was no significant difference in the levels of CD8 and CD4/ CD8 in patients with vitiligo (P <0.05). Compared with normal controls, the CD3 decreased in peripheral blood of patients with vitiligo, and there were significant differences (0. 01P0. 05); CD4 decreased, and there was very significant difference (P <0.05). There was no significant statistical difference between CD8 and CD4/ CD8 levels (P 0.05). CD3, CD4, CD in peripheral blood of patients with vitiligo Compared with the control group, the levels of sIL-2R in peripheral blood of patients with vitiligo vulgaris were significantly higher than those of normal control group (P <0.05). (P 0.01), the level of TNF-VEP in peripheral blood increased, and there were significant statistical differences (0. 01P0. 05). The levels of IL-2R and TNF-IL were significantly different from those of normal control group (P 0.01). Compared with the control group, there was no significant difference in serum sIL-2R and TNF level (P 0.05). CD8 There was no significant difference in the levels of CD4/ CD8, sIL-2R and TNF-tau (P <0.05). Conclusion: 1. The abnormal cellular immune function of patients with vitiligo vulgaris in this group is mainly characterized by peripheral blood CD3, CD4 water. Compared with the normal control group, the level of CD8 and C was significantly lower than that in the control group. Compared with the control group, the levels of sIL-2R and TNF levels in peripheral blood were significantly higher than those in the control group. Compared with the group, the peripheral blood C of patients with vitiligo in the stage of progressive vitiligo The levels of CD3 and CD4 decreased significantly, and the levels of sIL-2R and TNF-2R were significantly higher, but there was no statistical difference compared with the control group. The abnormal cellular immune function of vitiligo patients with ordinary progression suggested that the pathogenesis of vitiligo is related to autoimmune diseases, and it also supports the theory of autoimmune disease of vitiligo. The peripheral blood CD3, CD4, CD8, CD4/ CD8, sIL-2R and TNF in each TCM syndrome type of vitiligo.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R758.41
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