老年类风湿关节炎患者外周血Th17和Treg变化及其与共患冠心病关系的探讨

Changes of Th17 and Treg in elderly patients with rheumatoid arthritis and their relationship to comorbid coronary artery disease

为分析老年类风湿关节炎(rheumatoid arthritis,RA)患者Th17和Treg变化与共患冠心病(coronary artery disease,CAD)的相关性,回顾性选取122例老年RA患者,其中未共患CAD者纳入无共患组(84例),共患CAD者纳入共患组(38例),使用FACS检测患者外周血Th17和Treg(CD25;、Foxp3;)水平,并计算Th17/Treg比值,分析其与共患CAD的相关性。结果显示,共患组患者外周血Th17水平高于无共患组(P=0.000),Treg水平低于无共患组(P=0.001),Th17/Treg比值高于无共患组(P=0.000);外周血Th17、Th17/Treg比值与心血管共患症发生呈正相关(r=0.814,P=0.003;r=0.623,P=0.000),而Treg与心血管共患症发生呈负相关(r=-0.824,P=0.002)。该研究提示,老年RA共患CAD患者存在明显的Th17、Treg亚群失衡及其免疫应答失衡,Th17、Treg可能与老年RA患者共患CAD有关。

To analyze the correlation between changes of Th17,Treg and comorbid coronary artery disease(CAD)in elderly patients with rheumatoid arthritis(RA),122 elderly RA patients were retrospectively selected,in which patients with simple RA(84 cases)and comorbid RA and CAD(38 cases)were included.The peripheral blood Th17 and Treg(CD25;,Foxp3;)were detected by FACS,the Th17/Treg ratio was calculated,and their correlation with comorbid CAD was analyzed.The results showed that the levels of peripheral blood Th17 were higher in the patients with CAD than those without CAD(P=0.000);the level of peripheral blood Treg in the comorbid group was lower than that in the non-comorbid group(P=0.001),and Th17/Treg ratio in the CAD comorbid group was higher than that in the non-comorbid group(P=0.000);therefore,Th17 level and Th17/Treg ratio in peripheral blood were positively correlated with cardiovascular comorbidity(r=0.814,P=0.003;r=0.623,P=0.000),while Treg was negatively correlated with cardiovascular comorbidity(r=-0.824,P=0.002).This study suggests that the imbalance between Th17 and Treg exists in elderly RA patients with CAD.Th17 and Treg may be related to CAD in elderly RA patients.