CAJ | 학술논문

目的探讨类风湿关节炎(RA)患者外周血T细胞亚群的变化情况,了解其变化在RA发病及炎症活动中的意义.方法采用流式细胞仪荧光抗体标记法分别对197例RA患者的外周血淋巴细胞进行CD3/CD8/CD45/CD4及CD3/CD16+56/CD45/CD19四色荧光抗体(B.D)标记,分析比较RA患者外周血淋巴细胞比例情况,并与RA疾病活动性评分(DAS28-4)、压痛关节数、肿胀关节数、晨僵时间、医生和患者对疼痛程度的视觉模糊评分(VAS)、血红细胞沉降率、C反应蛋白及血清学抗体行相关分析.结果 RA患者外周血淋巴细胞中CD3+CD19-、CD3+CD4+和CD3+CD8+T细胞占总淋巴细胞的百分率分别为(71.06±12.07)%、(45.13±36.14)%和(26.56±9.54)%,RA患者CD3+CD19-T细胞与DAS28-4、压痛关节数、肿胀关节数及患者VAS存在负相关(P<0.05).RA患者外周血CD3+CD4+T(Th)淋巴细胞与抗环瓜氨酸肽抗体呈明显负相关(r=-0.156,P=0.029),与抗角蛋白抗体、人抗核周因子抗体、类风湿因子无明显相关.合并肺间质病变组与未合并肺间质病变组T细胞和Ts细胞差异有统计学意义(Z=-2.159和-2.031,P=0.031和0.042),合并干燥综合征组与未合并干燥综合征组的免疫功能差异无统计学意义(P>0.05).结论 RA思者外周血T淋巴细胞存在比例的失衡,T淋巴细胞数量的异常可能是RA发病及炎症活动的重要影响因素.
목적 탐토류풍습관절염(RA)환자외주혈T세포아군적변화정황,료해기변화재RA발병급염증활동중적의의.방법 채용류식세포의형광항체표기법분별대197례RA환자적외주혈림파세포진행CD3/CD8/CD45/CD4급CD3/CD16+56/CD45/CD19사색형광항체(B.D)표기,분석비교RA환자외주혈림파세포비례정황,병여RA질병활동성평분(DAS28-4)、압통관절수、종창관절수、신강시간、의생화환자대동통정도적시각모호평분(VAS)、혈홍세포침강솔、C반응단백급혈청학항체행상관분석.결과 RA환자외주혈림파세포중CD3+CD19-、CD3+CD4+화CD3+CD8+T세포점총림파세포적백분솔분별위(71.06±12.07)%、(45.13±36.14)%화(26.56±9.54)%,RA환자CD3+CD19-T세포여DAS28-4、압통관절수、종창관절수급환자VAS존재부상관(P<0.05).RA환자외주혈CD3+CD4+T(Th)림파세포여항배과안산태항체정명현부상관(r=-0.156,P=0.029),여항각단백항체、인항핵주인자항체、류풍습인자무명현상관.합병폐간질병변조여미합병폐간질병변조T세포화Ts세포차이유통계학의의(Z=-2.159화-2.031,P=0.031화0.042),합병간조종합정조여미합병간조종합정조적면역공능차이무통계학의의(P>0.05).결론 RA사자외주혈T림파세포존재비례적실형,T림파세포수량적이상가능시RA발병급염증활동적중요영향인소.
Objective To study the change of T cell subsets in peripheral blood of patients with rheumatoid arthritis (RA) and investigate the significance of T cell 1 subsets change in the incidence and inflammatory activity of RA. Methods Four-color fluorescence flow cytometry was used to detect the CD3/CD8/CD45/CD4 and CD3/CD16 +56/ CD45/CD19 markers in the peripheral blood lymphocytes of 197 RA patients. The proportion of peripheral blood lymphocytes in RA patients was compared and correlation analysis was conducted between T cell subsets and disease activity indices which include disease activity score(DAS28-4) ,tender joint count (TJC) .swollen joint count(SJC) , time of morning stiffness, patient's global assessment of disease activity on a 100 mm VAS by doctor and patients, erythrocyte sedimentation rate, C-reactive protein and serum antibody. Results The proportions of CD3+CD19- , CD3+ CD4+ and CD3+ CD8+ T cells in peripheral lymphocytes were (71.06 ±12.07)% , (45.13 ±36.14)% and (26.56 ±9.54)% respectively in RA group. Correlation analysis indicated significant negative correlations of the proportions of CD3+ CD19- cells with DAS28-4, TJC, SJC and patient's global assessment of disease activity a 100 mm VAS by patients (P <0.05 ). Furthermore, CD3+ CD4+ T cells still showed significant negative correlation with the anti-CCP antibody (r =-0. 156,P =0. 029) , and no correlation with AKA, APF and RF. CD3+ CD19-and CD3+CD8 + T cells showed significant differences between the interstitial lung disease group and control group (Z=-2. 159 and -2.031, P= 0. 031 and 0.042). There was no significant difference between the Sj(o)gren' s Syndrome group and control group(P>0.05). Conclusion The proportion of T lymphocytes in peripheral blood of patients with RA and the abnormality of T lymphocytes may play an important role in the incidence and inflammatory activity of RA.