类风湿关节炎患者外周血中B细胞凋亡的研究

Apotosis of B cells in the peripheral blood of patients with rheumatoid arthritis

目的探讨类风湿关节炎（RA）患者外周血中B细胞的凋亡变化及临床意义。方法流式细胞术检测81例RA患者（其中活动期51例，缓解期30例）及80名健康对照者外周血B细胞表达比例。免疫磁珠法分选出10例活动期RA患者、10例缓解期RA患者和10名健康对照者外周血中B细胞，进行体外培养；分别在24、48、72、96h收集细胞，流式细胞术检测B细胞的凋亡率。采用单因素方差分析．t检验和Spearman相关分析进行统计分析。结果以CD19、CD22为标记的B细胞在活动期、缓解期RA患者及健康对照者外周血中比例分别为：（26±11）％、（12±8）％、（10±6），（26±10）％、（12±8）％、（11±5）％；活动期RA患者外周血B细胞比例显著高于缓解期和健康对照组（P〈0．01）。活动期RA患者外周血B细胞表达比例与疾病活动指数（DAS）28、血清IgG含量呈正相关（r=0．380，P=0．006；r=0．320，P=O．023），与其他临床参数无相关性。体外培养的活动期RA患者外周血B细胞凋亡率显著低于缓解期RA患者和健康对照组。结论活动期RA外周血中B细胞凋亡途径受到抑制，可能导致其外周血B细胞比例显著增高，且B细胞增高比例与疾病活动度密切相关。

Objective To investigate the clinical significance of apoptosis of B cells in the peripheral blood of patients with rheumatoid arthritis （RA）. Methods The proportions of B cells in the peripheral blood （PB） of 51 active and 30 remission patients with RA and 80 healthy controls were detected by flow cytometry. B cells in the PB of 10 active , 10 remission and 10 healthy individuals were isolated by MACS. The apoptosis of cultured B ceils, which were collected at 24, 48,72,96 h respectively ,were assessed by flow cytometry. ANOVA, t test and, Spearman correlation analysis were used for statistical analysis. Results The proportions of B cells marked as CD19 and CD22 in the PB of active and remission patients with RA and healthy controls were （26±11）%, （12±8）%, （10±7）%, （26±10）%, （12±8）%, （ 11±5）% respectively. The proportions of B cells in the PB of active patients was significantly higher than that of remission patients and healthy controls （P〈0.01）. There was positive correlation between B cell proportion in the PB of active patients and DAS 28 and IgG level. The proportion of apoptosis of B cells in the PB with active patients was less than healthy controls. Conclusion The pathway of apoptosis of B cells in the PB of active patients is inhibited, which could increase B cell proportion. Moreover, the high proportion of B cells in the PB of active patients is closely related to disease activity.