活动期类风湿关节炎蛋白质代谢变化及相关性分析

Changes in Protein of Patients with Rheumatoid Arthritis in Active Phase and Correlation Analysis

目的:观察类风湿关节炎(RA)患者蛋白质的变化及其相关性分析。方法:测定40例RA患者和20例正常对照组的PA、ALB、A/G、Apo-A1、Apo-B、HDL、LDL、Treg表达水平等,比较蛋白质各指标与Treg表达水平两者之间是否存在差异;分析蛋白质变化与生活质量、临床症状、活动性指标、焦虑自评量表(SAS)、抑郁自评量表(SDS)标准分、类风湿性关节炎活动度评分表(DAS-28)及调节T细胞等的相关性。结果:①活动期RA患者的PA、A/G、Treg水平较正常对照显著下降(P<0.01),40例RA患者PA下降的有37人,占92.5%;A/G下降的有21人,占47.5%。②TP、ALB与生理功能呈明显负相关(P<0.01或P<0.05);PA、ALB、A/G、HDL与DAS-28呈明显负相关(P<0.01或P<0.05);TP与心理功能、生活质量总计分呈明显负相关(P<0.05);GLO与DAS-28呈明显正相关(P<0.05);蛋白质指标与Treg水平无特殊相关性。③TP、ALB与步行时间呈明显负相关(P<0.01或P<0.05);④PA、ALB、TP、Apo-B与RBC、HB、Fe呈明显正相关(P<0.01或P<0.05);PA、ALB、A/G、HDL、Apo-A1与a1-AGP、CRP、ESR呈明显负相关(P<0.01或P<0.05);GLO与IgG、C3、ESR呈明显正相关(P<0.01或P<0.05);LDL与C4呈明显正相关(P<0.01);Apo-A1/B与PLT、IgM呈明显负相关(P<0.05)。结论:RA患者中存在蛋白质代谢的异常,具体表现为PA、A/G等指标水平明显下降,其变化与RA炎症活动有关,但与CD4+CD2+5CD1-27Treg表达水平关系有待进一步研究。

Objective：To observe changes of the rheumatoid arthritis （RA） patients and its associated in protein analysis.Methods：PA,ALB,A/G,Apo-A1,Apo-B,HDL,LDL and Treg expression levels were detected in 40 patients with RA in active phase （active group） and 20 normal controls （normal control group）.Comparison of protein expression levels of various indicators and Treg,whichever is whether differences exist between;analysis of the relevant between protein changes and the quality of life,clinical symptoms,activity indicators,Self-Rating Anxiety Scale （SAS）,self-rating depression scale （SDS） standard score,rheumatoid arthritis activity rating scale （DAS-28）,regulative T cells.Results：①In 40 active RA patients,PA,A /G,Treg levels was significantly declined as compared with normal control group,and 37 cases （92.5 %） of RA in active group had a decreased PA.,21 cases （47.5 %） of RA in active group had a decreased A/G.,②TP,ALB and physiological function have a negative correlation （P〈0.01 or P〈0.05）;PA,ALB,A/G,HDL and DAS-28 showed significant negative correlation （P〈0.01 or P〈0.05）;TP and psychological function,quality of life was negatively related to total hours （P〈0.05）;GLO was positively correlated with the DAS-28 （P〈0.05）;Every indicators level of protein have no special relevance with Treg.③TP,ALB and walking time have a negative correlation （P〈0.01 or P〈0.05）;④PA,ALB,TP,Apo-B was positively correlated with RBC,HB,Fe （P〈0.01 or P 0.05）;PA,ALB,A/G,HDL,Apo-A1 was significantly negatively correlated with a1-AGP,CRP,ESR （P〈0.01 or P〈0.05）;GLO was positively correlated with IgG,C3,ESR （ P〈0.01 or P〈0.05）;LDL was positively correlated with C4 （P〈0.01）;ApoA1/B was negatively correlation with PLT,IgM （P〈0.05）.Conclusion：RA patients have abnormal protein metabolism,specifically expressed in PA and A/G,significantly decreased,which is related to RA inflammation activity,but CD4^＋CD25^＋CD127^- Treg the relationship between expression level remains to be further studied.