CAJ | 학술논문

目的探讨类风湿性关节炎(RA)患者外周血环瓜氨酸肽(CCP)抗体、CD4+ CD25+调节性T细胞检测的意义.方法 54名符合1987年美国风湿病协会(ACR)修订的RA诊断标准的患者为实验组,20名正常体检健康人员做为对照组.用酶联免疫吸附试验(EUSA)检测血清CCP抗体,用流式细胞仪测定外周血CD4+ CD25+调节性T细胞水平,RA组患者均行双手和双足X线检查评价骨关节侵蚀情况.结果 RA组CCP抗体的阳性率为66.7％,较对照组明显增高(P＜0.01)；RA组及对照组CD4+ CD25+调节性T细胞表达水平分别为(3.41±1.83)％、(4.23±2.16)％,两组差异有统计学意义(P＜0.05)；RA患者CCP抗体阳性组与阴性组CD4+ CD25+调节性T细胞表达水平分别为(3.17±1.57)％、(3.59±1.84)％,差异无统计学意义(P＞0.05),两组骨关节侵蚀发生率分别为72.2％、16.7％,差异有统计学意义(P＜0.05),CCP抗体阳性组骨关节侵蚀率与CD4+ CD25+调节性细胞水平无明显相关(r=-0.126,P＞0.05).结论 CCP抗体可以作为RA的重要实验室检测指标；CCP抗体阳性RA患者较阴性患者更易发生骨关节侵蚀,但骨关节侵蚀的发生可能与CD4+ CD25+调节性T细胞的表达水平降低无关.
목적 탐토류풍습성관절염(RA)환자외주혈배과안산태(CCP)항체、CD4+ CD25+조절성T세포검측적의의.방법 54명부합1987년미국풍습병협회(ACR)수정적RA진단표준적환자위실험조,20명정상체검건강인원주위대조조.용매련면역흡부시험(EUSA)검측혈청CCP항체,용류식세포의측정외주혈CD4+ CD25+조절성T세포수평,RA조환자균행쌍수화쌍족X선검사평개골관절침식정황.결과 RA조CCP항체적양성솔위66.7％,교대조조명현증고(P＜0.01)；RA조급대조조CD4+ CD25+조절성T세포표체수평분별위(3.41±1.83)％、(4.23±2.16)％,량조차이유통계학의의(P＜0.05)；RA환자CCP항체양성조여음성조CD4+ CD25+조절성T세포표체수평분별위(3.17±1.57)％、(3.59±1.84)％,차이무통계학의의(P＞0.05),량조골관절침식발생솔분별위72.2％、16.7％,차이유통계학의의(P＜0.05),CCP항체양성조골관절침식솔여CD4+ CD25+조절성세포수평무명현상관(r=-0.126,P＞0.05).결론 CCP항체가이작위RA적중요실험실검측지표；CCP항체양성RA환자교음성환자경역발생골관절침식,단골관절침식적발생가능여CD4+ CD25+조절성T세포적표체수평강저무관.
Objective To investigate the significance of detecting cyclic citrullinated peptide (CCP) antibody and CD4+ CD25+ regulatory T cells (Treg) in rheumatoid arthritis (RA).Methods Fifty-four patients with RA as defined by ACR criteria were investigated as study group.The control group consisted of 20 healthy volunteers.The serum CCP antibody was detected by using enzyme linked immunosorbent assay (ELISA),the peripheral CD4+ CD25 + Treg were detected by using flow cytometry,and articular erosion was checked by using X-ray photograph.Results As compared with normal control group,the positive rate of serum CCP antibody (66.7％ ) was significantly increased (P ＜0.01 ),and that of peripheral blood CD4 + CD25 + Treg (3.41 ± 1.83 )％ was decreased significantly in RA group.There were no significant differences in the levels of CD4+ CD25+ Treg between the positive CCP antibody patients and the negative CCP antibody patients (P＞0.05),but there was significant difference in the rate of articular erosion (P ＜ 0.05).No significant correlation was found between the rate of articular erosion and the levels of CD4 + CD25 + Treg in the positive CCP antibody patients.Conclusion CCP antibody was a satisfactory marker for RA.Articular erosion occurred more possibly in positive CCP antibody RA patients than in negative CCP antibody patients,but it was irrelevant to the decrease of peripheral blood CD4 + CD25 + Treg.