CAJ | 학술논문

目的观察类风湿关节炎(RA)外周血单个核细胞(PBMC)磷酸二酯酶(PDEs)活性的变化及与间质性肺疾病(ILD)的关系,探讨PDEs在RA及RA-ILD发病机制中的作用.方法 67例初治活动期RA患者分为RA-ILD组30例和单纯RA组37例,同时设健康对照组20名,高效液相色谱法测定PBMCs中环磷酸腺苷(cAMP) PDEs的活性变化,并与患者的临床、实验室及肺损伤指标进行相关性分析.采用单因素方差分析、Student-Newman-Keuls检验、t检验、Spearman相关分析进行统计学分析.结果 ①RA患者PBMC-cAMP-PDEs活性(51±11)高于对照组(34±8,P＜0.01),其中RA-ILD组PBMC-cAMP-PDEs活性(58±10)高于单纯RA组(46±7,P＜0.0l).②RA患者PBMC-cAMP-PDEs水平与晨僵时间、关节压痛数、关节肿胀数、X线分期、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)以及28个关节疾病活动指数(DAS28)评分呈正相关(r值分别为0.432、0.441、0.527、0.430、0.466、0.616、0.662、0.519,P均＜0.01).③RA-ILD患者PBMC-cAMP-PDEs水平与ERS、CRP、RF、CT评分呈正相关(r值分别为0.466、0.616、0.662、0.488,P均＜0.01),与动脉血氧分压(PaO2)呈负相关(r=--0.563,P＜0.01),与肺活量(VC)及一氧化碳弥散吸收率(DLCO)无明显相关性(r值分别为0.118、-0.259,P＞0.05).结论 RA及RA-ILD患者免疫细胞内PDEs活性增高,并与RA疾病活动性及RA-ILD肺损伤严重程度有关,提示PDEs可能参与了RA及RA-ILD的发病过程.
목적 관찰류풍습관절염(RA)외주혈단개핵세포(PBMC)린산이지매(PDEs)활성적변화급여간질성폐질병(ILD)적관계,탐토PDEs재RA급RA-ILD발병궤제중적작용.방법 67례초치활동기RA환자분위RA-ILD조30례화단순RA조37례,동시설건강대조조20명,고효액상색보법측정PBMCs중배린산선감(cAMP) PDEs적활성변화,병여환자적림상、실험실급폐손상지표진행상관성분석.채용단인소방차분석、Student-Newman-Keuls검험、t검험、Spearman상관분석진행통계학분석.결과 ①RA환자PBMC-cAMP-PDEs활성(51±11)고우대조조(34±8,P＜0.01),기중RA-ILD조PBMC-cAMP-PDEs활성(58±10)고우단순RA조(46±7,P＜0.0l).②RA환자PBMC-cAMP-PDEs수평여신강시간、관절압통수、관절종창수、X선분기、홍세포침강솔(ESR)、C반응단백(CRP)、류풍습인자(RF)이급28개관절질병활동지수(DAS28)평분정정상관(r치분별위0.432、0.441、0.527、0.430、0.466、0.616、0.662、0.519,P균＜0.01).③RA-ILD환자PBMC-cAMP-PDEs수평여ERS、CRP、RF、CT평분정정상관(r치분별위0.466、0.616、0.662、0.488,P균＜0.01),여동맥혈양분압(PaO2)정부상관(r=--0.563,P＜0.01),여폐활량(VC)급일양화탄미산흡수솔(DLCO)무명현상관성(r치분별위0.118、-0.259,P＞0.05).결론 RA급RA-ILD환자면역세포내PDEs활성증고,병여RA질병활동성급RA-ILD폐손상엄중정도유관,제시PDEs가능삼여료RA급RA-ILD적발병과정.
Objective To investigate the changes and significance of phosphodiesterase (PDEs)activity in peripheral blood lymphocyte (PBMC) of rheumatoid arthritis (RA) patients with or without interstitial lung disease (ILD).Methods Sixty-seven treatment naive patients with active RA were divided into RA-ILD group (n=30) and non-ILD group (n=37),meanwhile,20 healthy person were enrolled as the healthy control group.High performance liquid chromatography (HPLC) were performed to determine the activity of cyclic adenosine monophosphate (cAMP) PDEs in PBMCs of patients in each group,and the correlation of PDEs activity with clinical,laboratory indicators of the disease severity and lung damage level were studied.One way ANOVA,Student-Newman-Keuls test,t test,Spearman's correlation analysis were used for statistical analysis.Results (① The PBMC-cAMP-PDEs activity in RA patients (51±11) was higher than that of the control group (34±8,P＜0.01),and PBMC-cAMP-PDEs activity in RA-ILD group (58±10)was higher than non-ILD group (46±7,P＜0.01).② The PBMC-cAMP-PDEs level in RA patients was positively correlated to the duration of morning stiffness,tender joint count,swollen joint count,X-ray installments,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),rheumatoid factor (RF) and DAS28 score (r=0.432,0.441,0.527,0.430,0.466,0.616,0.662,0.519,respectively,P＜0.01).③ The PBMC-cAMP-PDEs level of RA-ILD patients was positively correlated to ESR,CRP,RF,CT score(r=0.466,0.616,0.662,0.488,respectively,P＜0.01),and was negatively correlated to arterial partial pressure of oxygen(PaO2) (-0.563,P＜0.01).There was no significant correlation between PBMC-cAMP-PDEs level and vital capacity (VC) and carbon monoxide diffusing absorption closing rate (DLCO) (r=0.118,-0.259,P＞0.05).Conclusion The PDEs activity in immune cells is increased in patients with RA or RA-ILD and is associated with the activity of RA and severity of RA-ILD lung injury.The results of this study suggest that PDEs may be involved in RA and RA-ILD pathogenesis.