Objective To investigate the effect of longdan - xiegan capsules on the levels of IL - 10,IL - 23 ,TNF - α,INF - γ in the plasma of patients with positive HLA - B27 acute anterior uveitis( AAU). Methods Sixtyeight cases with positive HLA - B27AAU were randomly allocated into two groups. There were 36 cases in the treatment group treated with corticosteroids combined Longdan - xiegan capsules,and 32 cases in the control group treated simply with corticosteroids, and 19 healthy volunteers were as normal control groups. All cases were detected for HLA - B27 by the method of PCR. And the IL - 10 , IL - 23 ,TNF - α, INF -γ expression in sera of the patients were measured by the ELISA technology before and after treatment. Results The levels of the IL - 23 ,TNF - α, INF - γ in AAU patients were significant increased compared with the normal group( P < 0. 01) . They were significantly lower after treatment ( P < 0. 01) compared with the acute phase. After treatment, the TNF - α, IL - 23 levels of the treatment group was close to normal group ( P, = 0. 84, P2 = 0. 54) ,but the control group was still higher than the normal group (P1 =0. 035 ,P2 =0. 003) . The IFN - γ level of the treatment and control group were still higher than the normal group( P1 = 0. 043 , P2 =0. 017). The IL - 10 level in AAU patients were significantly higher than the normal group( P < 0. 01). After treatment, It was significantly higher than before in the control group( P = 0. 029 ) , while in the treatment group it was deceased more certain degree( P = 0. 027) , close to normal group (P = 0. 100). (3 ) IFN - γ ,TNF - α, IL - 10 level and IL - 23 level showed a positive correlation before treatment. Conclusion Corticosteroids combined longdan - xiegan capsules have significantly effect on the expression of cytokines in the patients with positive HLA - B27 AAU. It can accommodate patient's immunity unbalance and effectively restrain the inflammation.%目的 观察龙胆泻肝胶囊对HLA-B27相关性急性前葡萄膜炎(AAU)患者治疗前后外周血中IL-10、IL-23、TNF-α、INF-γ等细胞因子水平的变化,探讨其可能的作用机制.方法 68例AAU患者随机分为龙胆泻肝胶囊加激素治疗组(治疗组)36例42眼及单纯激素治疗组(对照组)32例37眼,并与19例健康人群对比.对患者进行HLA-B27及外周血血浆上述4种因子水平检测.结果 治疗组及对照组IFN-γ、TNF-α、IL-23在AAU发作期显著高于健康人群(P＜0.01),且治疗后均显著降低(P＜0.01)；其中TNF-α、IL-23治疗后治疗组水平下调接近健康人群(P＞0.05),但对照组仍高于健康人群(P1＜0.05,P2＜0.01)；IFN-γ在治疗后两组均高于健康人群(P＜0.05).IL-10在治疗前均显著高于健康人群(p＜0.01),治疗后对照组较治疗前升高(P＜0.05),而治疗组呈一定程度下降(P＜0.05),基本接近健康人群(P=0.10).IL-10测定结果与其他3者基本一致,相关系数均达0.8以上.结论 糖皮质激素结合龙胆泻肝胶囊能显著调节HLA-B27相关性急性前葡萄膜炎患者的相关血清细胞因子水平,改善患者体内的免疫失衡状态,是其可能的作用机制之一.
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