血清抗血管内皮细胞抗体、调节性T细胞及血小板参数在类风湿关节炎患者中的变化与病情活动、预后的关系

The relationship between the changes in AECA,regulatory T cells and platelet parameters in patients with rheumatoid arthritis and the disease activity and prognosis

目的研究血清抗血管内皮细胞抗体(Anti endothelial cell anti-bodies,AECA)、调节性T细胞及血小板参数在类风湿关节炎(RA)患者中的变化与病情活动、预后的关系。方法我院接受诊治的120例RA患者为研究组,根据患者类风湿关节炎患者的疾病情况分为活动期及缓解期各60例;选取同期健康检查的正常人群96例为对照组。收集受检患者临床资料,比较各组AECA、调节性T细胞及血小板参数;记录所有患者在随访时间内预后情况,分析影响RA患者预后不良的危险因素。结果(1)研究组AECA、调节性T细胞及血小板各参数水平高于对照组(P<0.05);(2)活动期与缓解期患者AECA、调节性T细胞及血小板各参数水平高于对照组,且活动期各指标水平高于缓解期(P<0.05);(3)随访显示,预后良好82例,预后不良38例,预后不良率31.66%。(4)患者AECA阳性数、调节性T细胞、血小板计数、血小板比容、平均血小板体积及血小板分布宽度异常为RA患者预后不良的独立危险因素(P<0.05)。结论AECA、调节性T细胞及血小板参数在RA患者中明显升高,且与患者预后关系密切,可作为预测RA患者预后的分子标志物和治疗的潜在靶点。

Objective To explore the relationship between the changes in anti-endothelial cell anti-bodies(AECA),regulatory T cells,and platelet parameters in rheumatoid arthritis(RA)patients and the disease activity and prognosis.Methods Clinical data of 120 RA patients who were diagnosed and treated in our hospital were selected as study group.According to the disease status of the patients,they were divided into active phase group and remission phase group,60 in each group.At the same time,96 people who underwent health examinations were selected as control group.The clinical data of the tested patients were collected to compare the levels of AECA,regulatory T cells and platelet parameters among the groups.The prognosis of all patients during the follow-up period was recorded.Multiple logistic regressionanalysis was used to analyze the risk factors that affect the poor prognosis of RA patients.Results(1)The levels of AECA,regulatory T cells and platelets in the study group were significantly higher than those in the control group(P<0.05).(2)The levels of AECA,regulatory T cells and platelets of patients in active and remission phases were significantly higher than those in the control group,and the levels of AECA,regulatory T cells and platelets of patients in active phase were higher than those in remission phase(P<0.05).(3)Follow-up results showed that 82 patients had a good prognosis and 38 patients had a poor prognosis.The poor prognosis rate was 31.66%.(4)Multiple logistic regression analysis showed that the number of positive AECA,regulatory T cells,platelet count,platelet hematocrit,average platelet volume and abnormalities of platelet distribution width were independent risk factors for poor prognosis in RA patients(P<0.05).Conclusion AECA,regulatory T cells and platelet parameters were significantly increased in RA patients,and closely related to the prognosis of patients.These indexes can be used as molecular markers for predicting the prognosis of RA patients and potential targets for treatment.