类风湿关节炎病人外周血T细胞亚群的表达及意义

STUDY ON T CELL SUBGROUP IN PERIPHERAL BLOOD OF PATIENTS WITH RHEUMATOID ARTHRITIS

目的:探讨类风湿关节炎(rheumatoid arthritis,RA)病人外周血T细胞亚群的变化与RA发病机制及疾病发生发展的的关系。方法:检测50例RA病人和30例正常人进行外周血T细胞亚群的细胞数(流式细胞术)、类风湿因子及CRP(免疫沉淀法)、ESR(魏氏法),同时记录临床观察项目。结果:(1)活动期RA病人与健康对照组比较,外周血CD3+T淋巴细胞、CD4+T淋巴细胞无明显变化,差异无统计学意义(P>0.05);CD8+T淋巴细胞数明显减少,CD4+/CD8+比值增加,差异有统计学意义(P<0.05)。(2)活动期RA病人外周血CD8+T淋巴细胞的降低、CD4+/CD8+比值的升高,与缓解期RA病人比较差异具有统计学意义(P<0.05)。(3)缓解期RA病人与健康对照组比较,外周血T细胞亚群变化无统计学意义(P>0.05)。(4)缓解期与活动期RA病人比较,各临床参数均有明显改善。结论:异常细胞免疫状态参与了RA的发病过程,且与疾病的发生发展有关,CD4+/CD8+比值在RA的诊治中具有重要临床意义。

Objective：To analyze the relationship between variation of T cell subgroup in peripheral blood （ PB ） and pathogenesis and development of rheumatoid arthritis （RA）. Methods： Sera from 50 patients with RA and 30 controls, T cell subgroup in PB was detected by flow cytometry. RF and CRP were detected by immuno - precipitation. ESR was examined by Westergren method, and recording the clinical observation items. Results： （1）There was no statistical difference between RA in active stage and controls about CD3＋ and CD4＋ （ P 〉 0. 05 ）. CD8＋ increased in RA which had difference with CD8 ＋ T cell in PB reduced obviously and CD4 ＋/ controls（P 〈0. 05）. （2）CD8 ＋ T cell in PB reduced and CD4 ＋/CD8 ＋ increased of RA in active stage which had difference with RA in remission stage （P 〈0. 05）. （3）There was no statistical difference between RA in remission stage and controls about variation of T cell subgroup in PB （P 〉 0. 05）. （4）The clinical parameter of RA in remission stage had more obvious improvement than RA in active stage. Conclusion：Abnormal cell immune plays a role in RA＇s pathogenesis and development. CD4＋/CD8＋ rate have important clinical significance for RA＇s diagnosis and treatment.