风湿病贫血患者B,T淋巴衰减因子的观察

Observation of B, T lymphoid attenuation factors in rheumatic patients with anemia

目的观察风湿病患者贫血情况及B,T淋巴衰减因子(BTLA)表达。方法选取314例风湿病患者,类风湿关节炎(RA)患者104例,干燥综合征(SS)患者56例,强直性脊柱炎(AS)患者92例,膝骨关节炎(KOA)患者62例。采用全自动血细胞分析仪检测红细胞(RBC)、血红蛋白(Hb)等表达;采用流式细胞术检测患者外周血BTLA表达,观察风湿病患者贫血情况及其相关性分析。结果与正常参考值比较,有101例(32%)风湿病患者发生贫血。分别为RA患者53例(51%),SS患者22例(39%),AS患者15例(14%),KOA患者11例(18%)。与贫血组比较,不伴贫血组CD3+BTLA+T cell、CD4+BTLA+T cell明显升高;RBC、CRP、ESR、IgA计数明显降低。相关性分析同时显示,Hb与CD3+BTLA+T cell、CD4+BTLA+T cell、RBC呈正相关,而与CRP、ESR、IgA等炎症活动性指标呈负相关。结论风湿病患者伴有贫血的发生,BTLA表达失衡使得炎性因子表达升高,对造血功能产生抑制,破坏外周血红细胞,引起机体贫血。

To observe the expression of B, T lymphoid attenuation factor （BTLA） in rheumatism patients with anemia, total of 314 cases of rheumatic diseases, include rheumatoid arthritis （RA, 104 cases）, Sjogren＇s syndrome （SS, 56 cases）, ankylosing spondylitis （AS, 92 cases）, and knee osteoarthritis （KOA, 62 cases） were enrolled. Automatic blood cell analyzer was used to detect the expressions of erythrocytes （RBC） and hemoglobin （Hb）, while flow eytometry was applied for BTLA expression of peripheral blood in patients. We found that there were 101 cases of anemia （32%） in rheumatic patients, 53 cases in RA （51%） patients, 22 eases in SS （39%）, 15 cases in AS （14%）, and 11 cases in KOA （18%）. Compared with anemia patients, patients without anemia demonstrated higher levels of CD3＋BTLA＋T cell and CD4＋BTLA＋ T cell, but lower levels of RBC, CRP, ESR, and IgA. Correlation analysis showed that Hb was positively correlated with CD3＋BTLA＋ T cell, CD4＋BTLA＋T cell, and RBC, but negatively correlated with CRP, ESR, and IgA. In conclusion, the incidence of anemia may due to BTLA expression imbalance which makes expression of inflammatory cytokines increased, inhibits hematopoietic function, and damages peripheral red blood cells, causing the body anemia in patients with rheumatism.