外周血T细胞亚群及NGAL与RA动脉粥样硬化的关系

Relationship between peripheral blood T cell subsets,NGAL and RA atherosclerosis

目的:研究外周血CD4^+T、CD8^+T细胞、Th17细胞和中性粒细胞明胶酶相关脂质运载蛋白(NGAL)表达情况与类风湿关节炎(RA)患者动脉粥样硬化的关系。方法:选取2017年1月~2019年6月我院收治的114例RA患者为研究组,选取同时段于我院体检健康志愿者60例为对照组,比较两组受试者外周血CD4^+T、CD8^+T细胞、Th17细胞和NGAL表达差异。根据颈动脉内膜中层厚度(IMT)将患者分为无斑块组(40例)及有斑块组(74例),分析外周血各血清指标与动脉粥样硬化指数(AI)的相关性,以及影响动脉粥样硬化发生的危险因素。结果:研究组患者CD4^+T、Th17水平显著高于对照组,而CD8^+T水平显著低于对照组(P<0.05)。无斑块组患者CD8^+T水平显著高于有斑块组,而CD4^+T、Th17、NGAL、AI水平显著低于有斑块组(P<0.05)。Pearson相关性分析结果显示AI与CD4^+T、Th17、NGAL呈正相关,与CD8^+T呈负相关(P<0.05)。Logistic回归分析显示CD4^+T、Th17、NGAL、CD8^+T均是导致RA患者发生动脉粥样硬化的危险因素(P<0.05)。结论:RA患者外周血T细胞亚群和NGAL表达情况与动脉粥样硬化密切相关,其中外周血CD4^+T、Th17细胞和NGAL可增加RA患者发生动脉粥样硬化的风险。

Objective:To study relationship between expressions of CD4^+T,CD8^+T cells,Th17 cells and NGAL in peripheral blood and atherosclerosis in RA patients.Methods:A total of 114 RA patients admitted to our hospital from January 2017 to June 2019 were selected as study group,and 60 healthy subjects in the same period were selected as control group.Expressions of CD4^+T,CD8^+T cells,Th17 cells and NGAL in peripheral blood of two groups were compared.According to carotid intima-media thickness,the patients were divided into non-plaque group(40 cases)and plaque group(74 cases).The correlation between serum parameters of peripheral blood and atherosclerosis index and the risk factors affecting the occurrence of atherosclerosis were analyzed.Results:The levels of CD4^+T and Th17 in the study group were significantly higher than those in the control group,while the levels of CD8^+T were significantly lower than those in the control group(P<0.05).The levels of CD8^+T in the non-plaque group were significantly higher than those in the plaque group,while the levels of CD4^+T,Th17,NGAL and AI were significantly lower than those in the plaque group(P<0.05).Pearson correlation analysis showed that AI was positively correlated with CD4^+T,Th17 and NGAL,and negatively correlated with CD8^+T(P<0.05).Logistic regression analysis showed that CD4^+T,Th17,NGAL and CD8^+T were all risk factors for atherosclerosis in RA patients(P<0.05).Conclusion:The expression of peripheral blood T cell subsets and NGAL in peripheral blood of RA patients is closely related to atherosclerosis.CD4^+T,Th17 cells and NGAL in peripheral blood can increase the risk of atherosclerosis in RA patients.