不同中醫(yī)體質(zhì)類型的慢性HBV感染者與HLA-A2、特異性CTL、PD-1相關(guān)性研究
發(fā)布時間：2018-11-25 09:08
【摘要】：目的:探討不同中醫(yī)體質(zhì)類型的慢性HBV感染者HLA-A2等位型、特異性CTL及PD-1的變化;闡明HLA-A2等位型、特異性CTL及PD-1在慢性HBV感染中的狀態(tài);明確慢性HBV感染者不同中醫(yī)體質(zhì)分型與特異性CTL、HLA-A2等位型、PD-1、HBeAg、HBV-DNA載量等指標(biāo)的相關(guān)性。方法:應(yīng)用王琦教授設(shè)計的的《中醫(yī)體質(zhì)分類與判定表》,對本院收治的152例慢性HBV感染者進(jìn)行一般資料調(diào)查(包括性別、年齡及發(fā)病時間、病史等)和中醫(yī)體質(zhì)類型判定。檢測受試者肝功能、HBeAg、HBV-DNA、HLA-A2等位型、特異性CTL及PD-1等指標(biāo)。應(yīng)用統(tǒng)計數(shù)據(jù)進(jìn)行分析,探討慢性HBV感染者的中醫(yī)體質(zhì)類型分布的規(guī)律,以及不同中醫(yī)體質(zhì)類型與肝功能、HBeAg、HBV-DNA、HLA-A2等位型、特異性CTL及PD-1等指標(biāo)的關(guān)系。結(jié)果:符合納入標(biāo)準(zhǔn)的慢性HBV感染者共152例,其中濕熱質(zhì)有60例(25.4%),其次為氣虛質(zhì)54例(22.9%),氣郁質(zhì)52例(22.1%),痰濕質(zhì)40例(17.0%),瘀血質(zhì)18例(7.6%),陰虛質(zhì)10例(4.2%),陽虛質(zhì)2例(0.8%),無平和質(zhì)及特稟質(zhì)患者。不同中醫(yī)體質(zhì)類型的分布與患者的性別及年齡有關(guān),且差異有統(tǒng)計學(xué)意義(P0.05)。不同中醫(yī)體質(zhì)類型的慢性HBV感染者,其HBeAg陽性陰性分布及HBV-DNA載量分布也不相同,且差異有統(tǒng)計學(xué)意義。但不同中醫(yī)體質(zhì)類型的肝功能指標(biāo)之間差義無明顯意義(P0.05)。本研究中,95%的患者HLA-A2等位型陽性,故未將其與中醫(yī)體質(zhì)類型、PD-1等指標(biāo)進(jìn)行詳細(xì)分析。特異性CTL與肝功能之間未顯示顯著相關(guān)性,PD-1與HBV-DNA載量呈正相關(guān),四種主要體質(zhì)類型中特異性CTL與PD-1分布不同,且差異具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:慢性HBV感染者的中醫(yī)體質(zhì)類型主要為濕熱質(zhì)、氣虛質(zhì)、氣郁質(zhì)、痰濕質(zhì),其次是瘀血質(zhì)、陰虛質(zhì)、陽虛質(zhì),本研究中未見平和質(zhì)和特稟質(zhì),且男性多于女性。青壯年慢性HBV感染者的中醫(yī)體質(zhì)主要以濕熱質(zhì)、痰濕質(zhì)為主,而中老年慢性HBV感染者的中醫(yī)體質(zhì)主要以氣虛質(zhì)、氣郁質(zhì)為主。本研究中慢性HBV感染者中醫(yī)體質(zhì)類型的分布與HLA-A2等位型未見明顯相關(guān)性,慢性HBV感染者中醫(yī)體質(zhì)類型的分布與HBeAg、HBV-DNA、特異性CTL及PD-1具有相關(guān)性�？傊�,通過對慢性HBV感染者進(jìn)行中醫(yī)體質(zhì)分型,了解該患者的中醫(yī)體質(zhì)特征,深入了解不同中醫(yī)體質(zhì)慢性HBV感染者的免疫應(yīng)答狀況,對于豐富、拓展中西醫(yī)結(jié)合治療肝病的研究內(nèi)涵有著重要理論和應(yīng)用價值。
[Abstract]:Objective: to investigate the changes of HLA-A2 allele, specific CTL and PD-1 in chronic HBV infected patients with different TCM physique types, and to elucidate the status of HLA-A2 allele, specific CTL and PD-1 in chronic HBV infection. To determine the correlation between different TCM constitution types and specific CTL,HLA-A2 allele and PD-1,HBeAg,HBV-DNA load in chronic HBV infected patients. Methods: general data (including sex, age, time of onset, history of disease) and type of constitution of TCM were investigated in 152 cases of chronic HBV infection in our hospital by using the classification and judgement table of TCM constitution designed by Professor Wang Qi. Liver function, HBeAg,HBV-DNA,HLA-A2 allele, specific CTL and PD-1 were detected. The distribution rule of TCM constitution type of chronic HBV infection and the relationship between different TCM constitution type and liver function, HBeAg,HBV-DNA,HLA-A2 allele, specific CTL and PD-1 were analyzed by statistical data. Results: there were 152 cases of chronic HBV infection, including 60 cases of dampness and heat (25.4%), 54 cases of deficiency of qi (22.9%), 52 cases of stagnation of qi (22.1%), 40 cases of phlegm and dampness (17.0%). There were 18 cases of blood stasis (7.6%), 10 cases of yin deficiency (4.2%), 2 cases of yang deficiency (0.8%). The distribution of different TCM physique types was related to gender and age of patients, and the difference was statistically significant (P0.05). The positive and negative distribution of HBeAg and the distribution of HBV-DNA load in chronic HBV infected patients with different physique types of TCM were different, and the difference was statistically significant. However, there was no significant difference between liver function indexes of different TCM physique types (P0.05). In this study, 95% of the patients were positive for HLA-A2 allele, so they were not analyzed in detail with TCM physique type and PD-1. There was no significant correlation between specific CTL and liver function, but there was a positive correlation between PD-1 and HBV-DNA load. The distribution of specific CTL and PD-1 was different among the four main physique types, and the difference was statistically significant (P0.05). Conclusion: the main types of TCM constitution of chronic HBV infection are dampness and heat, qi deficiency, qi stagnation, phlegm and dampness, followed by blood stasis, yin deficiency and yang deficiency. The Chinese medicine constitution of the young and middle-aged patients with chronic HBV infection is mainly dampness and heat, phlegm and dampness, while that of the middle-aged and aged chronic HBV infection is mainly qi deficiency and qi stagnation. In this study, there was no significant correlation between the distribution of TCM constitution type and HLA-A2 allele in chronic HBV infection, but there was a correlation between the distribution of TCM constitution type and HBeAg,HBV-DNA, specific CTL and PD-1 in chronic HBV infection. In short, through the TCM constitution classification of chronic HBV infected persons, to understand the TCM physique characteristics of this patient, and to deeply understand the immune response status of chronic HBV infected persons with different TCM constitutions, It is of great theoretical and practical value to expand the research connotation of integrated traditional Chinese and western medicine in the treatment of liver diseases.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
本文編號：2355565
[Abstract]:Objective: to investigate the changes of HLA-A2 allele, specific CTL and PD-1 in chronic HBV infected patients with different TCM physique types, and to elucidate the status of HLA-A2 allele, specific CTL and PD-1 in chronic HBV infection. To determine the correlation between different TCM constitution types and specific CTL,HLA-A2 allele and PD-1,HBeAg,HBV-DNA load in chronic HBV infected patients. Methods: general data (including sex, age, time of onset, history of disease) and type of constitution of TCM were investigated in 152 cases of chronic HBV infection in our hospital by using the classification and judgement table of TCM constitution designed by Professor Wang Qi. Liver function, HBeAg,HBV-DNA,HLA-A2 allele, specific CTL and PD-1 were detected. The distribution rule of TCM constitution type of chronic HBV infection and the relationship between different TCM constitution type and liver function, HBeAg,HBV-DNA,HLA-A2 allele, specific CTL and PD-1 were analyzed by statistical data. Results: there were 152 cases of chronic HBV infection, including 60 cases of dampness and heat (25.4%), 54 cases of deficiency of qi (22.9%), 52 cases of stagnation of qi (22.1%), 40 cases of phlegm and dampness (17.0%). There were 18 cases of blood stasis (7.6%), 10 cases of yin deficiency (4.2%), 2 cases of yang deficiency (0.8%). The distribution of different TCM physique types was related to gender and age of patients, and the difference was statistically significant (P0.05). The positive and negative distribution of HBeAg and the distribution of HBV-DNA load in chronic HBV infected patients with different physique types of TCM were different, and the difference was statistically significant. However, there was no significant difference between liver function indexes of different TCM physique types (P0.05). In this study, 95% of the patients were positive for HLA-A2 allele, so they were not analyzed in detail with TCM physique type and PD-1. There was no significant correlation between specific CTL and liver function, but there was a positive correlation between PD-1 and HBV-DNA load. The distribution of specific CTL and PD-1 was different among the four main physique types, and the difference was statistically significant (P0.05). Conclusion: the main types of TCM constitution of chronic HBV infection are dampness and heat, qi deficiency, qi stagnation, phlegm and dampness, followed by blood stasis, yin deficiency and yang deficiency. The Chinese medicine constitution of the young and middle-aged patients with chronic HBV infection is mainly dampness and heat, phlegm and dampness, while that of the middle-aged and aged chronic HBV infection is mainly qi deficiency and qi stagnation. In this study, there was no significant correlation between the distribution of TCM constitution type and HLA-A2 allele in chronic HBV infection, but there was a correlation between the distribution of TCM constitution type and HBeAg,HBV-DNA, specific CTL and PD-1 in chronic HBV infection. In short, through the TCM constitution classification of chronic HBV infected persons, to understand the TCM physique characteristics of this patient, and to deeply understand the immune response status of chronic HBV infected persons with different TCM constitutions, It is of great theoretical and practical value to expand the research connotation of integrated traditional Chinese and western medicine in the treatment of liver diseases.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
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