CAJ | 학술논문

目的探讨类风湿关节炎(RA)患者外周血B淋巴细胞及自然杀伤(NK)细胞的变化情况,了解其变化在类风湿关节炎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例类风湿关节炎患者的外周血淋巴细胞进行CD3/CD8/CD45/CD4及CD3/CD16 CD56/CD45/CD19四色荧光抗体(B.D)标记,分析比较类风湿关节炎患者外周血淋巴细胞比例情况,并与类风湿关节炎疾病活动性评分(DAS28)、压痛关节数、肿胀关节数、晨僵时间、医生和患者对疾病活动性的整体评价(VAS)、血红细胞沉降率、C反应蛋白及血清学抗体(AKA,APF,RF,CCP)及是否合并感染等并发症进行相关分析.结果类风湿关节炎组外周血淋巴细胞中CD3-CD19+细胞和CD3-CD16+CD56细胞占总淋巴细胞数的百分率分别为(12.09±3.47)%和(15.02±2.56)%;类风湿关节炎患者外周血CD3-CD19+细胞和CD3-CD16+CD56+细胞与DAS28呈明显正相关(P<0.05);CD3-CD19+细胞数值与血清抗环瓜氨酸肽抗体水平呈正相关(P<0.05);比较出现感染的患者其免疫功能与未发生感染的患者之间CD3-CD19+细胞数值,CD3-CD16+CD56+细胞数值差异有统计学意义(P<0.05);比较出现肺间质病变的患者其免疫功能与未发生肺间质病变的患者之间CD3-CD19+细胞数值差异有统计学意义(P<0.05);比较合并干燥综合征的患者CD3-CD19-+细胞数值、CD3-CD16+CD56+细胞数值与未发生干燥综合征的患者差异无统计学意义(P>0.05).结论类风湿关节炎患者外周血淋巴细胞存在比例失衡,CD3-CD19+细胞和CD3-CD16+CD56+细胞数量的异常可能是类风湿关节炎发病、炎症活动及合并感染的重要影响因素.
목적 탐토류풍습관절염(RA)환자외주혈B림파세포급자연살상(NK)세포적변화정황,료해기변화재류풍습관절염발병급염증활동중적의의.방법 채용류식세포의형광항체표기법분별대197례류풍습관절염환자적외주혈림파세포진행CD3/CD8/CD45/CD4급CD3/CD16 CD56/CD45/CD19사색형광항체(B.D)표기,분석비교류풍습관절염환자외주혈림파세포비례정황,병여류풍습관절염질병활동성평분(DAS28)、압통관절수、종창관절수、신강시간、의생화환자대질병활동성적정체평개(VAS)、혈홍세포침강솔、C반응단백급혈청학항체(AKA,APF,RF,CCP)급시부합병감염등병발증진행상관분석.결과 류풍습관절염조외주혈림파세포중CD3-CD19+세포화CD3-CD16+CD56세포점총림파세포수적백분솔분별위(12.09±3.47)%화(15.02±2.56)%;류풍습관절염환자외주혈CD3-CD19+세포화CD3-CD16+CD56+세포여DAS28정명현정상관(P<0.05);CD3-CD19+세포수치여혈청항배과안산태항체수평정정상관(P<0.05);비교출현감염적환자기면역공능여미발생감염적환자지간CD3-CD19+세포수치,CD3-CD16+CD56+세포수치차이유통계학의의(P<0.05);비교출현폐간질병변적환자기면역공능여미발생폐간질병변적환자지간CD3-CD19+세포수치차이유통계학의의(P<0.05);비교합병간조종합정적환자CD3-CD19-+세포수치、CD3-CD16+CD56+세포수치여미발생간조종합정적환자차이무통계학의의(P>0.05).결론 류풍습관절염환자외주혈림파세포존재비례실형,CD3-CD19+세포화CD3-CD16+CD56+세포수량적이상가능시류풍습관절염발병、염증활동급합병감염적중요영향인소.
Objective To explore B cells and natural killer(NK)cells changes in pefipheral blood of rheumatoid arthritis(RA)patients to understand the role of the changes in RA patients and inflammation activities of disease.Methods All the RA patients selected into this study were divided into different disease activity group according to Disease Activity Score(DAS28).The peripheral blood mononuclear cells were cultured in vitro.The lymphocytes were marked by four-color fluorescent antibody of CD3/CD4/CD8/CD19 and CD16/CD3/CD19/CD56,and then detected lymphocyte by flow cytometry.We markered and detected the number of the T phenotype cells,B phenotype cells,NK phenotype cells.The correlation between the lymphocyte and diseases activity score,tenderness joint swelling of the joints number,morning stiffness time,doctors and patients to disease activity glogal assessment(VAS),red blood cell subsidence ratio,C.reactive protein and serological antibody was analyzed.Results The proportions of the CD3-CD19+cell and the CD3-CD16+CD56+cell in peripheral iymphocytes was(12.09±3.47)%and(15.02±2.56)%respectively in RA group.Correlation analysis indicated significant negative correlations of the proportions of CD3-CD19+cells with DAS28-4 and a-ccp(P<0.05).Furthermore,CD3+CD19-and CD1-CD19+ cells still showed significant correlation between with pSS and ILD and without(P<0.05).Conclusion There is an imbalance in the proportions of the CD3-CD19+cell and the CD3-CD16+CD56+cell in peripheral iymphocytes with RA.The abnormality of iymphocytes may be a coincidence in the inflammation and infection in patients with RA.