溃疡性结肠炎患者免疫功能状态的临床研究

Clinical study of immune function in patients with ulcerative colitis

目的研究溃疡性结肠炎(UC)患者外周血T细胞亚群、红细胞免疫、免疫球蛋白、补体及炎性介质的变化,探讨机体免疫功能变化在UC形成中的作用。方法纳入2014年10月至2015年10月我院收治的UC患者(观察组)、健康体检对象(对照组)各30例。取外周血测T细胞亚群(CD3+、CD4+、CD8+)水平、红细胞C3b受体花环率(RCR)、红细胞免疫复合物花环率(RICR)、血清红细胞C3b受体花环促进率(RFER)及抑制率(RFIR)、免疫球蛋白(Ig A、Ig G、Ig M)水平、补体(C3、C4)水平、炎性介质(TNF-α、IL-6、s IL-2R)水平。结果观察组CD3+明显低于对照组,CD4+/CD8+水平明显高于对照组;观察组RCR、RFER明显低于对照组、RICR、RFIR明显高于对照组;观察组TNF-α、IL-6、s IL-2R水平均明显高于对照组(P均<0.05)。两组其它指标未见明显差异。结论溃疡性结肠炎患者存在T细胞亚群紊乱、红细胞免疫功能缺陷、炎症因子水平上升等现象,监测上述指标有助于评价病情变化,值得关注。

Objective To investigate the changes of T cell subsets, erythrocyte immunity, immune globulin, complement and inflammatory mediators in patients with ulcerative colitis （UC）, and explore the role of immune function in the formation of UC. Methods 30 patients with UC （observation group） and healthy physical examination （control group） were treated in our hospital from October 2015 to October 2014. The levels of T, CD4^＋, CD3^＋receptor （CD8＋）, erythrocyte C3b receptor （RCR）, erythrocyte immune complex （RICR）, inhibition rate （RFIR）, IgA （ IgG）, IgM （C4）, TNF- （ IL-6） and C3b （ sIL-2R） were measured. Results the CD3^＋ levels in the observation group were significantly lower than those in the control group, the CD4^＋/CD8^＋ level was significantly higher than that in the control group, the RCR and RFER in the observation group were signifi-cantly lower than those in the control group, RICR and RFIR were significantly higher than those in the control group, the levels of IL-6, sIL-2R and TNF- in the observation group were significantly higher than those in the control group. Statistically significant differences were significant （P 〈 0.05）. There was no significant difference in other indexes in the two groups. Conclusion T cell subsets disorder, red cell immune function defects,and inflammatory factors increase occur in patients with UC and monitoring these indicators is helpful to evaluate the state of UC.