滑膜巨噬细胞与类风湿关节炎病情活动及关节破坏的相关性

Relationship between synovial macrophage and disease activity or articular damage in rheumatoid arthritis

目的 了解类风湿关节炎（ＲＡ） 滑膜巨噬细胞与病情活动性及关节破坏的相关性以探讨其检测的临床意义。方法 采用ＣＤ６８ 免疫组化ＬＳＡＢ染色法检测了ＲＡ、非ＲＡ及正常滑膜巨噬细胞，并分析ＲＡ 滑膜衬里下层浸润的巨噬细胞数与ＲＡ 病情活动指标及Ｘ 线关节破坏指标之间的关系。结果 ＲＡ 滑膜衬里下层浸润的巨噬细胞数较非ＲＡ 滑膜明显增多，其不仅与关节疼痛数、关节压痛数、ＥＳＲ、ＣＲＰ等ＲＡ 病情活动指标呈明显的正相关，而且还与Ｘ 线关节破坏的侵蚀积分和狭窄积分呈明显的正相关（Ｐ＜ ０－０５ 或Ｐ＜０－０１）。结论 滑膜巨噬细胞的检测有助于ＲＡ 的病情判断（包括病情活动性及关节破坏） 及预后分析。

Objective To know the clinical significance of synovial macrophage detection in rheumatoid arthritis (RA).Methods Synovial macrophage was detected by immunohistochemical LSAB method in synovia from RA or non RA patients and normal controls,and the correlation between infiltrated synovial macrophage number in sublining area and RA disease activity indicators or radiologic articular damage indicators was analysed.Results The results showed more sublining macrophages in RA synovia than that of non RA synovia and there was significant positive correlation between sublining macrophage number and pain joint count,tender joint count,ESR ,CRP or radiologic Sharp score ( P <0 05 or P <0 01).Conclusion Synovial macrophage detection is helpful for diagnosing RA disease activity and estimating prognosis.