沙利度胺治疗类风湿关节炎的效果及对患者Th17和Treg细胞分化平衡的影响

Influonce of Thalidomide in the treatment of rheumatoid arthritis and the influence on the balance of differentiation of Th17 and Treg cells

目的观察沙利度胺对类风湿关节炎(RA)患者Th17细胞与Treg细胞分化平衡的影响。方法选取2018年6月~2019年10月我院收治的80例RA患者作为研究对象,按照随机数字表法将入选患者分为治疗组与对照组,各40例。同时选取在我院体检的40名健康人群作为健康组。对照组患者给予常规治疗,治疗组在对照组的基础上加用沙利度胺。比较两组患者治疗后的临床效果,观察两组患者治疗前后及健康组的Th17细胞比例、Treg细胞比例及Th17/Treg细胞比值。结果治疗组的总有效率为95.00%,高于对照组的75.00%,差异有统计学意义(P<0.05)。治疗组及对照组治疗前的Th17细胞比例、Th17/Treg细胞比值高于健康组,Treg细胞亚群比例低于健康组,差异有统计学意义(P<0.05)。治疗组及对照组治疗后的Th17细胞比例、Th17/Treg细胞比值高于健康组,Treg细胞亚群比例低于健康组,差异有统计学意义(P<0.05)。治疗组及对照组治疗前的Th17、Treg细胞比例及Th17/Treg值比较,差异无统计学意义(P>0.05)。两组患者治疗后的Th17细胞比例、Th17/Treg细胞比值低于治疗前,Treg细胞亚群比例高于治疗前,差异有统计学意义(P<0.05)。治疗组治疗后的Th17细胞比例、Th17/Treg细胞比值低于对照组,Treg细胞亚群比例高于对照组,差异有统计学意义(P<0.05)。结论沙利度胺能够调节Th17与Treg细胞的平衡,是对Treg与Th17细胞亚群的平衡机制的重要补充,能够为RA和其他自身免疫性疾病的治疗提供一条潜在的新途径。

Objective To observe the influence of Thalidomide on the differentiation balance of Th17 cells and Treg cells in rheumatoid arthritis(RA)patients.Methods A total of 80 RA patients admitted to our hospital from June 2018 to October 2019 were selected as research objects,according to the method of random number table,the selected patients were divided into the treatment group and the control group,40 cases in each group.Meanwhile,40 healthy people who had physical examination in our hospital in the same period were selected as the healthy group.The patients in the control group were given routine treatment,while the patients in the treatment group were given Thalidomide on the basis of the control group.The clinical effects of the two groups were compared,the ratio of Th17 cells,Treg cells and Th17/Treg cells were observed before and after treatment of the two groups.Results The total effective rate of the treatment group was 95.00%,which was higher than 75.00%of the control group,the difference was statistically significant(P<0.05).The ratio of Th17 cells and Th17/Treg cells in the treatment group and the control group before treatment were higher than those in the healthy group,and the ratio of Treg cell subsets in the treatment group and the control group before treatment were lower than those in the healthy group,the differences were statistically significant(P<0.05).The ratio of Th17 cells and Th17/Treg cells in the treatment group and the control group before treatment were higher than those in the healthy group,and the ratio of Treg cell subsets in the treatment group and the control group after treatment were lower than those in the healthy group,the differences were statistically significant(P<0.05).There were no significant differences in Th17,Treg cell proportion and Th17/Treg between the treatment group and the control group before treatment(P>0.05).The ratio of Th17 cells and Th17/Treg cells after treatment in the two groups of patients were lower than those before treatment,and the ratio of Treg cell subsets after treatment in the two groups of patients were higher than those before treatment,the differences were statistically significant(P<0.05).The ratio of Th17 cells and Th17/Treg cells in the treatment group after treatment were lower than those in the control group,and the ratio of Treg cell subsets in the treatment group after treatment was higher than that in the control group,the differences were statistically significant(P<0.05).Conclusion Thalidomide can regulate the balance of Th17 and Treg cells,which is an important supplement to the balance mechanism of Treg and Th17 cell subsets,and can provide a potential new way in the treatment of RA and other autoimmune diseases.