活动期类风湿关节炎患者外周血T、B淋巴细胞及NK细胞表达变化的意义

Expression significance of T lymphocytes,B lymphocytes and natural killer cells in peripheral blood of patients with active rheumatoid arthritis

目的探讨活动期类风湿关节炎(RA)患者外周血T淋巴细胞亚群CD4^+/CD8^+、B淋巴细胞及自然杀伤(NK)细胞的表达变化及与疾病活动度的相关性。方法收集2016年1~6月在第三军医大学西南医院住院的28例中重度活动期RA患者[DAS28(4)ESR:3.21~7.80](RA组)和30例健康人(正常对照组)的外周血。采用流式细胞技术检测外周血T淋巴细胞亚群、B淋巴细胞、NK细胞的百分比及绝对计数,并作统计分析。结果与健康对照组比较,RA组外周血中CD3^+CD4^+T细胞亚群百分比明显上升[(47.46±12.10)%比(40.85±7.70)%,P<0.05],CD3^+CD8^+T细胞亚群的百分比差异无统计学意义(P>0.05),CD3^+CD4^+/CD3^+CD8^+T细胞比值显著增高[(2.41±1.42)比(1.57±0.61),P<0.05],淋巴细胞计数、总的T淋巴细胞百分比及计数、CD3-CD19^+B淋巴细胞百分比及计数、CD3-CD16^+CD56^+NK细胞百分比及计数两组比较,差异无统计学意义(P>0.05)。相关性分析显示RA组中DAS28(4)ESR与T淋巴细胞亚群百分比及比值无相关性(P>0.05)。结论外周血T淋巴细胞亚群CD4^+/CD8^+比值失衡在活动期RA的发病中可能发挥了重要作用。

Objective To investigate the expression of CD4＋/CD8＋, B lymphocytes and natural killer （NK） cells in pe- ripheral blood of patients with active rheumatoid arthritis （RA） and their correlation with the disease activity. Methods From January 2016 tO June 2016, in Southwest Hospital of Third Military Medical University, the peripheral blood samples of 28 RA patients with moderate to severe disease activity [DAS28 （4） ESR： 3.21-7.80] （RA group） and 30 health persons （normal control group） were collected. The flow cytometry was used to detect the T lymphocyte subsets, B lymphocyte amt NK cell percentage and absolute counts. According to the homogeneity of variance, the statistical analysis was ap- plied by t test or rank sum test. Results Compared with normal control group, the percentage of CD3＋CD4＋ T lympho cytes was increased significantly in peripheral blood of RA group [（47.46±12.10） % vs （40.85±7.70）%, P 〈 0.05], there was no statistically significant difference of the percentage of CD3＋CD8＋ T lymphocytcs （P 〉 0.05）, CD3＋CD4＋/CD3＋CD8CF cell ra- tio significantly increased [（2.41±1.42） vs （1.57±0.61）, P 〈 0.05], there were no statistically significant differences of the count and percentage of Lymphocyte, total T lymphocyte, CD3 CD19＋B lymphocyte, CD3 CD16＋CD56＋NK cells （P 〉 0.05）. Correlation analysis showed that the DAS28 score and the percentage or ratio of T lymphocyte subgroups in RA had no correlation. Conclusion The imbalance of CD4＋/CD8＋ ratio of T lymphocyte subgroups in peripheral blood may play an important role in the pathogenesis of RA.