系统性红斑狼疮中医证型与人类白细胞Ⅱ类抗原DR基因表达关系的研究

目的 观察系统性红斑狼疮（SLE）各中医证型患者外周血单个核细胞(PBMC)的人类白细胞Ⅱ类抗原DR(HLA-DR)基因的表达，以探求SLE中医辨证分型的客观化参考指标。方法 SLE患者辨证分型后，采取外周血，用流式细胞仪检测PBMC中的淋巴细胞、单核细胞表面HLA-DR抗原水平。结果 PBMC HLA-DR阳性淋巴细胞、单核细胞水平，脾肾阳虚型较其他各型显著降低（P<0.01）；阴虚内热型HLA-DR阳性淋巴细胞，较气阴两虚型和肝肾阴虚型均显著升高（P<0.01）；肝肾阴虚型HLA-DR阳性淋巴细胞显著高于气阴两虚型患者（P<0.05）；脾肾阳虚型PBMC中总体HLA-DR阳性细胞较其他各型显著降低（P<0.01）；阴虚内热型总体HLA-DR阳性细胞较气阴两虚型（P<0.01）和肝肾阴虚（P<0.05）均显著升高；气阴两虚型与肝肾阴虚型总体HLA-DR阳性细胞差异无统计学意义（P>005）。结论 HLA-DR可能为SLE中医辨证分型的客观化参照指标。

Relationship between TCM Syndrome Type and Expression of Human Leucocyte Antigen DR Gene in Patients with Systemic Lupus Erythematosus

OBJECTIVE: To explore the expression of human leucocyte antigen DR (HLA-DR) gene in peripheral blood mononuclear cells (PBMCs) of systemic lupus erythematosus (SLE) patients of various TCM syndrome types in order to seek an objective index for syndrome differentiation of SLE. METHODS: SLE patients were sorted into various syndrome types by TCM syndrome differentiation, i. e. Pi-Shen yang-deficiency type (A), yin-deficiency with internal heat type (B), qi-yin deficiency type (C) and Gan-Shen yin-deficiency type (D). Their peripheral blood sample was collected for detecting HLA-DR positive lymphocytes and monocytes in PBMC using flow cytometry. RESULTS: Comparisons among patients of various syndrome type showed that the proportion of HLA-DR positive monocytes and lymphocytes in PBMC in patients of type A was the lowest (P < 0.01); proportion of HLA-DR positive lymphocytes in patients of type B was significantly higher than in those of type C and D (P < 0.01), and that in type D was higher than in type C (P < 0.05); total proportion of HLA-DR positive cells in patients of type A was the lowest, that in type B was higher than that in type C and D (P < 0.01, P < 0.05), while no significant difference was found between the latter two types (P > 0.05). CONCLUSION: HLA-DR could be taken as an objective index for reference in syndrome differentiation of SLE.