CAJ | 학술논문

目的探讨抗肿瘤坏死因子-α人鼠嵌合单克隆抗体英夫利西单抗(infliximab)治疗前后类风湿关节炎(RA)患者外周血单核细胞CD147表达的变化.方法 30例经甲氨蝶呤(MTX)治疗至少3个月病情仍处于活动期的RA患者按3:1:1比例由计算机程序产生随机分配方案分为A、B、C 3组,A组接受为期14周的英夫利西单抗(3 mg/kg)治疗;B组接受为期6周的英夫利两单抗(3 mg/kg)治疗;C组接受为期14周的安慰剂治疗.治疗期间继续口服原剂量的MTX.流式细胞术检测RA患者外周血CD14+单核细胞CD147平均荧光强度水平(MFI)变化,并观察其与临床相关指标的关系.数据采用SPSS 13.0软件进行单因素方差分析、Spearman相关分析和Kruskal-Wallis秩和检验.结果 ①治疗前RA患者外周血CD14+单核细胞CD147 MFI为(101±25),健康志愿者为(78±18),差异有统计学意义(P=0.019).RA患者外周血CD147 MFI与病情活动指标DAS28(r=0.471,P=0.000)、红细胞沉降率(ESR)(r=0.371,P=0.000)、C反应蛋IQ(CRP)(r=0.249.P=0.010)、晨僵持续时间(r=279,P=0.010)呈正相关.②3组患者治疗后外周血CD14+单核细胞CD147 MFI均有下降,第18周与基线相比,A组平均改变差值(-26.9±21.7)、B组平均改变差值(-35.4±15.5)与C组平均改变差值(-10.0±6.0)相比,差异有统计学意义(P<0.05).结论活动期RA患者外周血CD14+单核细胞CD147表达增高;与单用MTX相比,英夫利西单抗联合MTX治疗CD147 MFI表达下降更明显.
목적 탐토항종류배사인자-α인서감합단극륭항체영부리서단항(infliximab)치료전후류풍습관절염(RA)환자외주혈단핵세포CD147표체적변화.방법 30례경갑안접령(MTX)치료지소3개월병정잉처우활동기적RA환자안3:1:1비례유계산궤정서산생수궤분배방안분위A、B、C 3조,A조접수위기14주적영부리서단항(3 mg/kg)치료;B조접수위기6주적영부리량단항(3 mg/kg)치료;C조접수위기14주적안위제치료.치료기간계속구복원제량적MTX.류식세포술검측RA환자외주혈CD14+단핵세포CD147평균형광강도수평(MFI)변화,병관찰기여림상상관지표적관계.수거채용SPSS 13.0연건진행단인소방차분석、Spearman상관분석화Kruskal-Wallis질화검험.결과 ①치료전RA환자외주혈CD14+단핵세포CD147 MFI위(101±25),건강지원자위(78±18),차이유통계학의의(P=0.019).RA환자외주혈CD147 MFI여병정활동지표DAS28(r=0.471,P=0.000)、홍세포침강솔(ESR)(r=0.371,P=0.000)、C반응단IQ(CRP)(r=0.249.P=0.010)、신강지속시간(r=279,P=0.010)정정상관.②3조환자치료후외주혈CD14+단핵세포CD147 MFI균유하강,제18주여기선상비,A조평균개변차치(-26.9±21.7)、B조평균개변차치(-35.4±15.5)여C조평균개변차치(-10.0±6.0)상비,차이유통계학의의(P<0.05).결론 활동기RA환자외주혈CD14+단핵세포CD147표체증고;여단용MTX상비,영부리서단항연합MTX치료CD147 MFI표체하강경명현.
Objective To observe the effect of infliximab combination therapy on the expression of CD147 on the peripheral CD14+ monocytes of active rheumatoid arthritis (RA) patients. Methods Thirty active RA patients who were refractory to MTX treatment were randomized into three groups (group A, B, C) with the proportion of 3:1:1. Group A and B received four or three infusions of infliximab (3 mg/kg), group C received four infusions of placebo. All three groups were added to a stable background of MTX. The mean fluorescence intensity (MFI) of CD147 expression on the peripheral CD14+ monocytes of RA patients and normal healthy controls were detected by flow cytometry analysis. Clinical and laboratory parameters were assessed before each infusion. One-way ANOVA, Kruskal-Wallis the MFI of CD147 expression at week 18 (P<0.05). Marked differences were observed between the infliximab + MTX group and the placebo + MTX group on the change of the MFI of CD147 expression from baseline to week 18 (P<0.05).Conclusion CD147 expression on the peripheral CD14+ monocytes of active RA patients is increased, and combination therapy of infliximab and MTX can inhibit the expression.