类风湿关节炎合并肺部感染患者外周血T淋巴细胞和NK细胞水平及其临床意义

Detection and clinical significance of peripheral blood T lymphocyte and NK cell levels in patients with rheumatoid arthritis complicated with pulmonary infection

目的探究类风湿关节炎(RA)合并肺部感染患者外周血T淋巴细胞和自然杀伤细胞(NK细胞)的水平及其临床意义。方法选取48例RA合并肺部感染患者作为RA合并感染组,64例RA未合并肺部感染患者作为RA未合并感染组,另选取同期于本院健康体检中心进行体检的30例健康成年人作为对照组。比较三组外周血T淋巴细胞亚群及NK细胞水平,比较稳定期与活动期RA合并与未合并肺部感染患者的T淋巴细胞亚群及NK细胞水平。结果RA合并感染组CD3^(+)(641.21±438.08)个/μl、CD4^(+)(171.58±96.42)个/μl、CD8^(+)(215.48±110.16)个/μl、CD4^(+)/CD8^(+)(0.82±0.26)、NK细胞(26.57±4.88)个/μl;RA未合并感染组CD3^(+)(1051.36±434.65)个/μl、CD4^(+)(308.07±101.69)个/μl、CD8^(+)(324.17±108.16)个/μl、CD4^(+)/CD8^(+)(0.96±0.24)、NK细胞(40.52±8.92)个/μl;对照组CD3^(+)(1403.00±402.77)个/μl、CD4^(+)(610.07±82.58)个/μl、CD8^(+)(532.47±168.45)个/μl、CD4^(+)/CD8^(+)(1.35±0.21)、NK细胞(365.15±117.61)个/μl。RA合并感染组、RA未合并感染组CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、NK细胞水平均低于对照组,差异有统计学意义(P<0.05)。RA合并感染组CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、NK细胞水平均低于RA未合并感染组,差异有统计学意义(P<0.05)。稳定期RA合并肺部感染患者CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、NK细胞水平均低于稳定期RA未合并肺部感染患者,差异有统计学意义(P<0.05);活动期RA合并肺部感染患者CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、NK细胞水平均低于活动期RA未合并肺部感染患者,差异有统计学意义(P<0.05)。结论合并肺部感染的RA患者T淋巴细胞、NK细胞明显偏低,T淋巴细胞及NK细胞可能在一定程度上对RA合并肺部感染发挥一定的预测价值,指导临床诊疗。

Objective To investigate the levels of peripheral blood T lymphocyte and natural killer(NK)cell levels in patients with rheumatoid arthritis(RA)complicated with pulmonary infection.Methods 48 RA patients with pulmonary infection were included in the RA combined infection group,64 RA patients without pulmonary infection were included in the RA uncombined infection group,and 30 healthy adults during the same period were selected as the control group.Comparison was made on peripheral blood T lymphocyte subsets and NK cell levels among the three groups,and the T lymphocyte subsets and NK cell levels of RA patients with or without pulmonary infection in stable and active phases.Results In RA combined infection group,the CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and NK cells were(641.21±438.08)/μl,(171.58±96.42)/μl,(215.48±110.16)/μl,(0.82±0.26),and(26.57±4.88)/μl;in RA uncombined infection group,the CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and NK cells were(1051.36±434.65)/μl,(308.07±101.69)/μl,(324.17±108.16)/μl,(0.96±0.24),and(40.52±8.92)/μl;in the control group,the CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and NK cells were(1403.00±402.77)/μl,(610.07±82.58)/μl,(532.47±168.45)/μl,(1.35±0.21),and(365.15±117.61)/μl.The CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and NK cells of the RA combined infection group,RA uncombined infection group were lower than those of the control group,and the difference was statistically significant(P<0.05).The CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and NK cells of the RA combined infection group were lower than those of RA uncombined infection group,and the difference was statistically significant(P<0.05).The levels of CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and NK cells in RA patients with pulmonary infection in stable phase were lower than those in RA patients without pulmonary infection in stable phase,and the difference was statistically significant(P<0.05).The levels of CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and NK cells in RA patients with pulmonary infection in active phase were lower than those in RA patients without pulmonary infection in active phase,and the difference was statistically significant(P<0.05).Conclusion T lymphocytes and NK cells in patients with pulmonary infection are obviously lower,which can play a certain predictive value for RA with pulmonary infection to a certain extent,and guide clinical diagnosis and treatment.