摘要
目的:研究CD4+、CD8+T淋巴细胞、TNF-α及其受体p55在肉芽肿性乳腺炎不同证型中的表达情况,探讨各因子与不同证型GLM的关系及GLM发病机制。方法:收集2017年1月—2018年12月于山东中医药大学附属医院乳腺外科住院手术治疗的GLM患者手术病理组织,总数为50例,按照中医证型分组:肝郁痰凝证(肿块期)(15例)、热毒炽盛证(脓肿期)(18例)、正虚毒恋证(溃后期)(17例),免疫组化法检测病理组织中的CD4+、CD8+T淋巴细胞、TNF-α及受体P55,分析各种指标在GLM不同证型中的表达及意义。结果:CD4+T淋巴细胞、TNF-α、P55在不同证型GLM中的表达为肝郁痰凝证(肿块期)>热毒炽盛证(脓肿期)>正虚毒恋证(溃后期);CD8+T细胞表达情况为肝郁痰凝证(肿块期)<热毒炽盛证(脓肿期)<正虚毒恋证(溃后期)。CD4+、CD8+T细胞在不同证型GLM的表达呈负相关;TNF-α、P55在不同证型GLM的表达变化呈正相关。TNF-α的表达与CD4+T细胞表达呈正相关,与CD8+T细胞表达呈负相关。结论:在肉芽肿性乳腺炎不同证型中,CD4+、CD8+、TNF-α、P55随着病情进展呈现表达强弱的变化,提示肉芽肿性乳腺炎与T细胞亚群水平失衡相关,免疫状态紊乱,机体发生过强的免疫应答,导致炎症迁延不愈。本研究对肉芽肿性乳腺炎提供不同的治疗思路。
Objective:To study the expressions of CD4+T lymphocytes,CD8+T lymphocytes,TNF-αand its receptor p55 in different syndromes of granulomatous mastitis(GLM),and to explore the possible relationship between the factors and GLM of different syndromes and the pathogenesis of GLM.Methods:The surgical pathological tissues of 50 GLM patients were collected and classified according to TCM syndromes,i.e.stagnation of liver-qi and phlegm(lump stage,15 cases),excessive toxic heat(abscess stage,18 cases),declined vital-qi(late stage,17 cases).The expressions of CD4+T lymphocytes,CD8+T lymphocytes,TNF-αand its receptor p55 in pathological tissues were detected by immunohistochemical method.The expressions and significance of the indicators were analyzed in different syndromes of GLM.Results:In terms of the expressions of CD4+T lymphocytes,TNF-αand receptor p55,the order from high to low was the pattern of stagnation of liver-qi and phlegm,pattern of excessive toxic heat and pattern of declined vital-qi.In terms of the expression of CD8+T lymphocytes,the order from the low to high was the pattern of stagnation of liver-qi and phlegm,pattern of excessive toxic heat and pattern of declined vital-qi.The expressions of CD4+T lymphocytes,CD8+T lymphocytes in GLM of different syndromes was negatively correlated;the expressions of TNF-αand P55 in GLM of different syndromes was positively correlated.The expression of TNF-αwas positively correlated with the expression of CD4+T lymphocytes and negatively correlated with the expression of CD8+T lymphocytes.Conclusion:Among the different types of granulomatous mastitis,the expressions of CD4+T lymphocytes,CD8+T lymphocytes,TNF-αand its receptor p55 change with the progression of the disease,suggesting that granulomatous mastitis is related to the imbalance of T cell subsets.Disorder of immune status and excessively strong immune responses will lead to protracted inflammation.This study provides different treatment ideas for granulomatous mastitis.
作者
刘晓菲
王楠
李斐斐
宋爱莉
张丽美
LIU Xiaofei;WANG Nan;LI Feifei;SONG Aili;ZHANG Limei(The First Clinical College of Shandong University of Traditional Chinese Medicine, Jinan 250335, China;Shandong Academy of Chinese Medicine, Jinan 250014, China)
出处
《中医药学报》
CAS
2020年第4期23-28,共6页
Acta Chinese Medicine and Pharmacology
基金
第六批全国老中医药专家学术经验继承工作
山东省医药卫生科技发展计划项目(2018WS191)
山东省重点研发项目(2015GSF119014)。
关键词
肉芽肿性乳腺炎
中医证型
T细胞亚群
肿瘤坏死因子
免疫组化
Granulomatous mastitis
TCM syndrome pattern
T cell subset
Tumor necrosis factor
Immunohistochemistry
作者简介
刘晓菲(1978-),女,博士,副教授,副主任医师,主要从事乳腺甲状腺外科的中医及中西医结合临床、教学及科研工作;通讯作者:张丽美(1978-),女,硕士,副研究员,研究方向:中医基础理论,中药药理与毒理。
