类风湿关节炎患者肠道黏膜屏障功能指标及sIgA表达与外周血淋巴细胞亚群的关系探讨

The relationship betweenthe indexes of intestinal mucosal barrier function and secreted IgA expression and the peripheral blood lymphocyte subsets in patients with rheumatoid arthritis

目的分析类风湿关节炎(RA)患者肠道黏膜屏障功能指标与分泌型免疫球蛋白A(sIgA)的表达情况及二者与外周血淋巴细胞亚群的关系。方法我院收治的RA患者(RA组)126例,同期体检的健康志愿者(对照组)81例。比较两组血清二胺氧化酶(DAO)、细菌内毒素、D-乳酸、sIgA水平及外周血淋巴细胞亚群变化情况;分析淋巴细胞亚群与DAO、D-乳酸、细菌内毒素及sIgA的关系。结果RA组DAO、细菌内毒素、D-乳酸水平高于对照组(P<0.05),sIgA水平低于对照组(P<0.05)。RA组总T淋巴细胞CD3^(+)、辅助/诱导T淋巴细胞CD4^(+)、抑制/杀伤T淋巴细胞CD8^(+)及NK淋巴细胞CD16^(+)CD56^(+)绝对计数低于对照组(P<0.05),两组B淋巴细胞CD19^(+)绝对计数比较,差异无统计学意义(P>0.05)。辅助/诱导T淋巴细胞CD4^(+)与血清DAO、细菌内毒素、D-乳酸水平呈负相关,与sIgA呈正相关(P<0.05),B淋巴细胞CD19^(+)与sIgA呈负相关(P<0.05)。结论RA患者DAO、细菌内毒素、D-乳酸水平升高,sIgA水平降低;二者与辅助/诱导T淋巴细胞CD4^(+)相关。

Objective To analyze the expressions of intestinal mucosal barrier function indexes and secreted immunoglobulin A(sIgA)in patients with rheumatoid arthritis(RA)and their relationship with peripheral blood lymphocyte subsets.Methods A total of 126 RA patients(RA group)and 81 healthy volunteers(control group)were enrolled.The levels of serum diamine oxidase(DAO),bacterial endotoxin,D-lactate and sIgA and changes in peripheral blood lymphocyte subsets were compared between the two groups.The relationship between the levels of DAO,D-lactate,bacterial endotoxin and sIgA and the lymphocyte subsets was analyzed.Results The levels of DAO,endotoxin and D-lactate were higher and sIgA level was lower of the RA group than those of the control group(P<0.05).The absolute counts of CD3^(+)T lymphocytes,CD4^(+)T helper/inducer T lymphocytes,CD8^(+)T suppressor/killer lymphocytes and CD16^(+)CD56^(+)NK lymphocytes in the RA group were lower than those in the control group(P<0.05).However,there was no significant difference in the absolute counts of CD19^(+)B lymphocytes between the two groups(P>0.05).CD4^(+)T lymphocytes was negatively correlated with serum levels of DAO,endotoxin and D-lactate,and positively correlated with sIgA(P<0.05).B lymphocyte CD19^(+)was negatively correlated with sIgA(P<0.05).Conclusions The levels of DAO,bacterial endotoxin and D-lactate in RA patients are increased while the level of sIgA is decreased.Both of them are associated with CD4^(+)T helper/inducer cells.