慢性乙型病毒性肝炎湿热量化的临床探讨

摘要

目的:探讨慢性乙型病毒性肝炎湿热症患者的临床量化规律.方法:选取2012年1月-2013年12月高要市人民医院消化内科住院部西医诊断慢性乙型病毒性肝炎,中医辨证属于湿热证患者101例,将患者分为两组,其中慢性乙型病毒性肝炎湿偏重证者作为A组(50例),慢性乙型病毒性肝炎热偏重证者作为B组(51例),同期选取肝功能正常,未合并肝脏疾病和湿热证的健康人群作为正常组(50例),酶联免疫吸附测定法(ELISA 法)检测尿液水通道蛋白2(AQP-2)、血清热休克蛋白70(HSP70)水平,同时用流式细胞仪检测外周血T淋巴细胞亚群的变化.结果:A、B组AQP-2均明显高于对照组,比较差异均具有统计学意义(P<0.05),其中A组AQP-2明显高于B组,两组比较差异具有统计学意义(P<0.05);A、B组HSP70均明显高于对照组,比较差异具有统计学意义(P<0.05),其中B组HSP70明显高于A组,两组比较差异具有统计学意义(P<0.05);A、B组CD4+、CD4+/CD8+均明显低于对照组,CD8+均明显高于对照组,比较差异具有统计学意义(P<0.05),A组和B组CD4+、CD8+、CD4+/CD8+比较差异均无统计学意义(P>0.05).结论:慢性乙型病毒性肝炎湿热证存在AQP-2、HSP70和CD8+等指标显著增加现象,同时存在CD4+、CD4+/CD8+等指标显著降低现象,其中慢性乙型病毒性肝炎湿偏重证者AQP-2增加程度更明显,热偏重证者HSP70增加程度更明显.%Objective:To investigate the clinical quantitative rules of chronic hepatitis B combined dampness-heat syndrome.Method:101 cases of chronic hepatitis B(Western medicine diagnosis) and dampness-heat syndrome inpatients internal medicine Department in People's Hospital of Gaoyao City from January 2012 to December 2013 were divided into two groups,chronic hepatitis B combined tend-to-dampness were selected as A group (50 cases),chronic hepatitis B combined tend-to- heat were selected as B group (51 cases), and in the same period,healthy people of normal liver function,unincorporated liver disease and syndrome of dampness heat were selected as normal group (50 cases), the urine aquaporin 2 (AQP-2) and heat shock protein 70 (heat shock protein 70, HSP70) level were detected by enzyme linked immunosorbent assay (ELISA) method, and peripheral blood T lymphocyte subsets were detected by flow cytometry.Result:AQP-2 of A,B group were significantly higher than that of control group,with significant difference (P<0.05), AQP-2 of A group was significantly higher than that of B group,with significant differences between the two groups (P<0.05).Plasma HSP 70 of A,B group were significantly higher than that of control group,with significant difference(P<0.05),plasma HSP70 of B group was significantly higher than that of A group,with significant differences between the two groups (P<0.05).CD4+, CD4+/CD8+ of A,B group were significantly lower than those of control group, CD8+ was significantly higher than that of control group,with significant difference (P<0.05),there were no significant difference of CD4+,CD8+,CD4+/CD8+ between A group and B group (P>0.05).Conclusion:The quantification indexes (AQP-2,HSP70,CD8+) of chronic hepatitis B with dampness-heat syndrome significantly increase,and quantitative index (CD4+,CD4+/CD8+)decrease,which AQP-2 of tend-to-dampness increase more obviously, HSP70 of tend-to-heat increases more obviously.