强直性脊柱炎患者外周血T细胞亚群及人类白细胞抗原-B27变化分析

Changes of T cell subsets and human leukocyte antigen-B27 in peripheral blood of patients with ankylosing spondylitis

目的分析强直性脊柱炎(ankylosing spondylitis,AS)患者外周血T细胞亚群及人类白细胞抗原-B27(human leukocyte antigen-B27,HLA-B27)变化,探讨其临床应用价值。方法选取本院2014年6月至2016年6月收治的108例AS患者纳入观察组,并选取同期于本院体检的90例健康者纳入对照组。使用流式细胞术检测两组受试者入组次日外周血T细胞亚群,使用磁珠酶联免疫法测定HLA-B27蛋白表达情况,并采用Pearson相关性分析探讨HLA-B27蛋白表达量与Bath强直性脊柱炎疾病活动指数(Bath ankylosing spondylitis disease activity index,BASDAI)的相关性。结果观察组患者Th2、CD3^+、CD4^+、CD19^+水平及CD4^+/CD8^+比值均显著高于对照组(P<0.05),Tc1和CD8^+水平均显著低于对照组(P<0.05)。观察组患者外周血HLA-B27蛋白表达量(0.61±0.19)显著高于对照组(0.08±0.03)(t=5.807,P<0.05)。观察组患者外周血HLA-B27阳性表达率(90.74%)显著高于对照组(0.00%)(χ~2=11.735,P<0.05)。观察组患者平均BASDAI评分为(4.89±1.33)分。Pearson相关性分析显示,AS患者外周血HLA-B27蛋白表达量与BASDAI评分呈正相关(r=0.571,P<0.05)。结论 AS患者外周血T细胞亚群紊乱,HLA-B27蛋白表达为阳性,其量与患者疾病活动度呈正相关,据此了解患者疾病状态并探索其发病机制,有望为AS的治疗提供新的思路。

Objective To analyze the changes of T cell subsets and human leukocyte antigen-B27（HLA-B27） in peripheral blood of patients with ankylosing spondylitis（AS）. Method 108 cases of AS patients admitted in our hospital from June 2014 to June 2016 were selected into observation group, 90 healthy persons in the medical examination during the same period were included in control group. Flow cytometry was used to detect the T cell subsets in the peripheral blood of the two groups, and the expression of HLA-B27 protein was measured by magnetic bead enzyme linked immunosorbent assay. The correlation between the expression of HLA-B27 protein and the Bath ankylosing spondylitis disease activity index（BASDAI） was analyzed by Pearson correlation analysis. Result The levels of Th2, CD3~＋, CD4~＋, CD19~＋ and CD4~＋/CD8~＋in observation group were significantly higher than control group（P〈0.05）, the levels of Tc1 and CD8~＋were significantly lower than control group（P〈0.05）. The expression of HLA-B27 protein in the peripheral blood of observation group（0.61±0.19） was significantly higher than control group（0.08±0.03）（t = 5.807, P〈0.05）. The positive expression of HLA-B27 in peripheral blood of observation group was 90.74%, control group was 0.00%, the difference was significant（χ~2= 11.735, P〈0.05）. The average BASDAI score of observation group was（4.89±1.33） points. Pearson correlation analysis showed that the expression of HLA-B27 protein in peripheral blood of AS patients was positively correlated with the BASDAI score（r = 0.571, P〈0.05）. Conclusion There is a disorder of T cell subsets in peripheral blood of AS patients, the expression of HLA-B27 is mostly positive, and its expression is positively correlated with the degree of disease activity in patients. It is good to understand the disease status of patients and explore its pathogenesis, which is expected to provide new ideas for the treatment of AS.