HLA-B27阳性类风湿关节炎和强直性脊柱炎患者外周血T细胞亚群分析

T Cell Subsets in Peripheral Blood of HLA-B27 Positive Rheumatoid Arthritis and Ankylosing Spondylitis Patients

目的探讨人类白细胞抗原B27(HLA-B27)阳性类风湿关节炎(RA)和强直性脊柱炎(AS)患者外周血T细胞亚群变化特点及其临床意义。方法应用流式细胞术分析受试患者及健康者CD4+T、CD8+T细胞百分率和CD4+T/CD8+T比值。结果 HLA-B27阳性RA患者CD4+T和CD8+T细胞百分率低于健康对照组,CD4+T/CD8+T比值高于健康对照组。HLA-B27阳性Ⅰ、Ⅱ级AS患者CD4+T细胞百分率和CD4+T/CD8+T比值低于健康对照组,CD8+T细胞百分率高于健康对照组;HLA-B27阳性Ⅲ级AS患者3项指标与健康对照组差异无统计学意义。HLA-B27阳性AS各级患者CD8+T细胞百分率和Ⅲ级患者CD4+T细胞百分率高于HLA-B27阳性RA患者,各级患者CD4+T/CD8+T比值低于HLA-B27阳性RA患者。结论外周免疫功能异常可能是HLA-B27阳性RA和AS发病机制之一,CD4+T/CD8+T比值有助于两者的鉴别诊断。

Objective To explore the changes and clinical significance of T cell subsets in peripheral blood of HLA-B27 positive rheumatoid arthritis（RA）and ankylosing spondylitis（AS） patients. Methods The ratio of CD4＋ T/CD8＋ T,and the percentages of CD4＋ T and CD8＋ T in peripheral blood were analyzed by flow cytometer. Results The percentage of CD4＋ T and CD8＋ T in HLA-B27 positive RA cases were lower than those in healthy controls, while the ratios of CD4＋ T/CD8＋ T increased. The percentages of CD4＋ T and the ratio of CD4＋ T/CD8＋ T in HLA-B27 positive grade Ⅰ and Ⅱ AS cases were lower than in healthy controls,the percentage of CD4＋ T was higher. Meanwhile,there were no significant differences of the percentage of CD4＋ T,CD8＋ T and the ratio of CD4＋ T/ CD8＋ T between HLA-B27 positive grade m AS cases and healthy controls. The percentage of CD8＋ T in all of HLA-B27 positive AS patients and the percentage of CD4＋ T in grade IlI cases were higher and the ratio of CD4＋ T/ CD8＋ T in all AS patients were lower than those in RA cases. Conclusion Dysfunction of periphery immune system may be in- volved in the immunopathogenesis of HLA-B27 positive RA and AS. The ratio of CD4＋ T/CD8＋ T is helpful for the antidiastole of the two diseases.