Tim-3血清水平对类风湿性关节炎疾病进展与免疫功能的影响

Effect of Tim-3 serum level on disease progression and immune function of rheumatoid arthritis

目的研究Tim-3血清水平对类风湿性关节炎疾病进展与免疫功能的影响。方法采取前瞻性研究,选取我院2017年2月~2021年2月收治的类风湿性关节炎患者120例作为研究对象,其中低度活动患者41例,中度活动患者35例,高度活动患者44例。另选取同期进行健康体检的志愿者120例作为对照组。比较观察组与对照组以及不同严重程度患者的免疫功能及Tim-3水平的差异。分析Tim-3血清水平对类风湿性关节炎疾病进展与免疫功能的相关性。结果观察组患者的CD4^(+)Tim-3(t=48.570,P=0.000)、CD8^(+)Tim-3(t=49.962,P=0.000)显著高于对照组;不同严重程度患者的CD4^(+)Tim-3(F=12.369,P=0.000)、CD8^(+)Tim-3(F=11.036,P=0.000)差异有统计学意义,经过两两比较,随着疾病进展,患者的CD4^(+)Tim-3、CD8^(+)Tim-3显著升高;观察组患者的CD3^(+)(t=99.665,P=0.000)、CD4^(+)(t=17.453,P=0.000)、CD4^(+)/CD8^(+)(t=6.811,P=0.000)显著低于对照组,CD8^(+)(t=7.935,P=0.000)显著高于对照组;不同严重程度患者的CD3^(+)(F=11.369,P=0.000)、CD4^(+)(F=10.396,P=0.000)、CD8^(+)(F=9.245,P=0.000)、CD4^(+)/CD8^(+)(F=9.663,P=0.000)差异有统计学意义,随着疾病进展,患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)显著降低,CD8^(+)显著上升;通过相关性分析,患者的CD4^(+)Tim-3、CD8^(+)Tim-3与CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)呈负相关,与CD8^(+)呈正相关。结论CD4^(+)T细胞以及CD8^(+)T细胞的Tim-3水平异常性上调,造成疾病活动度显著升高,Tim-3水平可通过调控体液免疫以及细胞免疫,参与类风湿性疾病的进展。

Objective To study the effect of Tim-3 serum level on disease progression and immune function of rheumatoid arthritis.Methods In this prospective study,120 patients with rheumatoid arthritis treated in our hospital from Feb 2017 to Feb 2021 were selected as the research object,including 41 patients with low activity,35 patients with moderate activity and 44 patients with high activity.120 volunteers who underwent physical examination at the same time were selected as control group.The differences of immune function and Tim-3 level between observation group and control group and patients with different severity were compared.Analyzed the correlation between Tim-3 serum level and rheumatoid arthritis disease progression and immune function.Results CD4^(+)Tim-3(t=48.570,P=0.000)and CD8^(+)Tim-3(t=49.962,P=0.000)in observation group were significantly higher than those in control group.There were significant differences in the levels of CD4^(+)Tim-3(F=12.369,P=0.000)and CD8^(+)Tim-3(F=11.036,P=0.000)in patients with different severity.After pairwise comparison,the levels of CD4^(+)Tim-3 and CD8^(+)Tim-3 increased significantly with the progression of the disease.The levels of CD3^(+)(t=99.665,P=0.000),CD4^(+)(t=17.453,P=0.000)and CD4^(+)/CD8^(+)(t=6.811,P=0.000)in observation group were significantly lower than those in control group,and CD8^(+)(t=7.935,P=0.000)was significantly higher than that in control group.There were significant differences in the levels of CD3^(+)(F=11.369,P=0.000),CD4^(+)(F=10.396,P=0.000),CD8^(+)(F=9.245,P=0.000)and CD4^(+)/CD8^(+)(F=9.663,P=0.000).With the progression of the disease,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)decreased significantly and CD8^(+)increased significantly.Through correlation analysis,CD4^(+)Tim-3 and CD8^(+)Tim-3 were negatively correlated with CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and positively correlated with CD8^(+).Conclusion The abnormal up regulation of Tim-3 levels of CD4^(+)T cells and CD8^(+)T cells further leads to a significant increase in disease activity,Tim-3 level can participate in the progression of rheumatoid diseases through the regulation of humoral and cellular immunity.