摘要
目的探讨非哺乳期乳腺炎患者外周血T淋巴细胞、免疫球蛋白及补体水平的变化情况。方法本研究纳入2010年3月至2011年4月间上海中医药大学附属龙华医院收治的72例非哺乳期乳腺炎患者(非哺乳期乳腺炎组)和30例健康体检者(正常对照组),检测其外周血T淋巴细胞(CD3+、CD4+、CD8+、CD56+CD16+)、免疫球蛋白(IgG、IgA、IgM)和补体(C3、C4、B因子)的水平。采用t检验比较非哺乳期乳腺炎组与正常对照组间各免疫指标的差异;用单因素方差分析比较不同发病年龄、不同生育情况、不同乳房炎性结块面积及有无先天性乳头畸形者与正常对照组间外周血T淋巴细胞、免疫球蛋白及补体水平的差异。结果非哺乳期乳腺炎患者CD3+T细胞、CD8+T细胞水平均低于正常对照组(P均<0.010),而CD56+16+NK细胞、IgM、C3、C4及B因子水平均高于正常对照组(P均<0.050)。生育高峰年龄组(25～34岁)和非生育高峰年龄组(21～24岁及35～44岁)CD3+T细胞、CD8+T细胞水平均低于正常对照组(P<0.050),C3、B因子水平则高于正常对照组(P<0.050);生育高峰年龄组C4水平高于正常对照组(P均<0.050)。生育状况对CD3+T细胞水平的变化有影响(P<0.050);分娩后≤2年发病组CD4+T细胞水平低于正常对照组(P<0.050);未生育组CD8+T细胞水平分别低于正常对照组、分娩后≤2年发病组和>2年发病组(P均<0.050);分娩后≤2年发病组和>2年发病组CD8+T细胞水平均低于正常对照组(P均<0.050),C3水平均高于正常对照组(P均<0.050);分娩后>2年发病组B因子水平高于正常对照组(P<0.050)。炎性结块面积>27.00cm2组CD3+T细胞和CD4+T细胞水平均低于炎性结块面积≤27.00cm2组和正常对照组(P均<0.050),CD56+CD16+NK细胞、IgA、C4及B因子水平则高于后两组(P均<0.050),CD8+T细胞水平低于正常对照组(P<0.050),C3水平高于正常对照组(P<0.050);炎性结块面积≤27.00cm2组CD3+T细胞和CD8+T细胞水平均低于正常对照组(P均<0.050),C3水平高于正常对照组(P<0.050)。有先天性乳头畸形组C3、B因子水平高于正常对照组(P均<0.050);无先天性乳头畸形组CD3+T细胞和CD8+T细胞水平均低于正常对照组(P均<0.050),C3、C4和B因子水平则高于后者(P均<0.050);有无先天性乳头畸形两组间各免疫指标比较差异却无统计学意义(P>0.050)。结论非哺乳期乳腺炎患者存在着免疫功能紊乱,其紊乱程度与发病年龄、生育状况及乳房炎性结块面积有关系。
Objective To investigate the variations of T lymphocytes, immunoglobulin and complements levels in peripheral blood in the patients with non-lactational mastitis. Methods Seventy-two patients with non-lactational mastitis and thirty healthy controls treated in Longhua Hosptial Affiliated to Shanghai University of Traditional Chinese Medicine from March 2010 to April 2011 were enrolled in this study.The expression levels of T lymphoeytes （CD3＋, CD4＋, CD8＋, CD56＋CD16＋）, immunoglobulins （IgG, IgA, IgM） and eomplements（ C3, C4, B factor） were determined respectively, t test was used to analyze the immune indices between the two groups. One-way factor analysis of varianee was performed to analyze the levels of T lymphoeytes, immunoglobulins and complements in peripheral blood of non-laetational mastitis patients according to the age of onset, fertility status, inflammatory breast agglomerate area, and congenital malformations of nipples. Results The CD3＋ and CD8＋ T cell levels were significantly lower in the patients with non-lactational mastitis than those in healthy controls （P〈0. 050）, while CD56＋CD16＋, IgM, C3, C4, B factors were significantly higher （P〈0. 050）. The levels of CD3＋ T cells and, CD8＋T cells in the patients at fertile peak age （25-34 years old） or at non-fertile peak age （21-24, 35-44 years old） were significantly lower than those in healthy controls （ P 〈 0. 050） ; C3 and B factor levels were higher than those in healthy controls （P〈0. 050）. The level of CA in patients at fertile peak age （25-34 years old） was higher than that in healthy controls （P〈0. 050）. The level of CD3＋T cell was effected by fertility status （P〈0. 050）. The level of CD4＋T cells in the patients with disease onset ＋ 2 years after delivery was lower than that in healthy controls; The level of CD8＋T cells in the patients who never give birth to children was lower than in healthy controls and in the patients with disease onset ＋〈 2 years, in the patients 〉 2 years after delivery（P〈0. 050）. The level of CD8＋ T cells in the patients with disease onset 〈＋ 2 years and 〉 2 years after delivery were lower than that in healthy controls （P〈0. 050）, while C3 level was higher than that in healthy controls （P〈0. 050）. The B factor level in the patients with disease onset 〉 2 years was higher than those of healthy control（ P〈0. 050）. The level of CD3＋T cells, CD4＋T cells in the patients with inflammatory agglomerate area 〉 27. 0 cmz were lower than those in the ones with the inflammatory agglomerate area ＋〈27 cm2（P〈0. 050）, and in healthy controls （P〈 0. 050）, while the levels of CD56＊ CD16＋NK cells, IgA, CA and B factor were higher than the other two groups （P〈0. 050）, and the levels of CD8 ＋T cells were lower than those of healthy controls （P〈0. 050）, the C3 level were higher than that of healthy controls （P〈0. 050）. The levels of CD3 ＋T cells, CD8＊T cells in the patients with inflammatory agglomerate area ≤ 27 cm2 were lower than those of healthy controls （ P〈0. 050）, while the C3 level were higher than that of healthy controls （P〈0. 050）. The levels of C3, B factor in the patients with congenital malformation of nipples were higher than those of healthy controls （P〈0. 050）. The levels of CD3 ＋T cells, CD8＋T cells in the patients without congenital malformation of nipples was were lower than those of healthy controls （P〈0. 050）, while the levels of C3, C4, B factor were higher than the later （P〈0. 050）. The levels of T lymphocytes, immunoglobulin and complements showed no difference in the two groups of patients with and without congenital malformation of nipples （P〈0. 050）. Conclusion Non-lactational mastitis patients have immune function disorder, and the severity of disorder is correlated with onset age, fertility status and inflammatory agglomerate area.
出处
《中华乳腺病杂志（电子版）》
CAS
2012年第5期17-24,共8页
Chinese Journal of Breast Disease(Electronic Edition)
基金
"十一五"国家支撑计划项目(2008BAI53B083)
浦东新区科技发展基金创新资金项目(PRJ2008-Y10)
