大动脉炎患者T淋巴细胞亚群、25-OH-D_(3)及PR3抗体变化与疾病活动性关系研究

Correlations between Changes of T Lymphocyte Subsets,25-OH-D_(3) and PR3 Antibodies with Disease Activity in Patients with Takayasu Arteritis

目的研究大动脉炎患者T淋巴细胞亚群、25-羟维生素D_(3)(25-OH-D 3)及蛋白酶3(PR3)抗体变化与疾病活动性关系。方法选取2018年5月—2020年5月本院收治的87例大动脉炎为大动脉炎组。根据美国Kerr评分标准分为活动组48例和非活动组39例。选取同期本院进行体检的健康者80例为对照组。比较各组T淋巴细胞亚群、25-OH-D 3及PR3抗体水平,分析影响大动脉炎活动的独立危险因素及T淋巴细胞亚群、25-OH-D_(3)、PR3抗体与Kerr评分的相关性。结果与对照组比较,大动脉炎组CD8+、25-OH-D_(3)水平降低,CD4+、CD4+/CD8+、PR3抗体水平升高(P<0.01)。与非活动组比较,活动组CD8+、25-OH-D_(3)水平降低,CD4+、CD4+/CD8+、PR3抗体水平增高(P<0.01)。T淋巴细胞亚群、25-OH-D_(3)及PR3抗体水平是影响大动脉炎活动发生的独立危险因素(P<0.01)。CD8+水平与Kerr评分呈负相关,CD4+、CD4+/CD8+、25-OH-D及PR3抗体水平与Kerr评分呈正相关(r=-0.467、0.426、0.498、0.024、0.459,P<0.05、<0.01)。结论T淋巴细胞亚群、25-OH-D_(3)及PR3抗体水平在大动脉炎中变化明显,是大动脉炎发生活动性改变的独立危险因素,且与疾病活动程度呈显著相关性。

Objective To study correlations between changes of T lymphocyte subsets,25-hydroxyvitamins D_(3)(25-OH-D 3)and protease 3(PR3)antibodies with disease activity in patients with takayasu arteritis.Methods A total of 87 patients with takayasu arteritis admitted between May 2018 and May 2020 were selected as takayasu arteritis group,and the patients were divided into active subgroup(n=48)and inactive subgroup(n=39)according to the American Kerr score.Another 80 healthy individuals who had undergone physical examinations at the same period were selected as control group.Levels of T lymphocyte subgroups,25-OH-D_(3) and PR3 antibodies were compared between groups.The independent risk factors affecting activities of patients with takayasu arteritis,and correlations between T lymphocyte subsets,25-OH-D_(3) and PR3 antibodies with Kerr score were analyzed.Results In takayasu arteritis group,levels of CD8+and 25-OH-D_(3) were significantly lower,while levels of CD4+,CD4+/CD8+and PR3 antibodies were significantly higher than those in control group(P<0.01).In active subgroup,CD8+and 25-OH-D_(3) levels were significantly lower,while levels of CD4+,CD4+/CD8+and PR3 antibodies were significantly higher than those in inactive subgroup(P<0.01).Levels of T lymphocyte subsets,25-OH-D_(3) and PR3 antibodies were independent risk factors affecting activities of takayasu arteritis(P<0.01).CD8+was negatively correlated with Kerr score,while levels of CD4+,CD4+/CD8+,25-OH-D_(3) and PR3 antibodies were positively correlated with Kerr score(r=-0.467,0.426,0.498,0.024,0.459,P<0.05,P<0.01).Conclusion Levels of T lymphocyte subgroups,25-OH-D_(3) and PR3 antibodies have obvious changes in patients with takayasu arteritis,and changes in levels of the above indicators are independent risk factors for changes in activities of patients with takayasu arteritis,and they are significantly correlated with the disease activity.