RA患者免疫功能失衡与疾病活动情况的关系研究

目的探讨类风湿关节炎(RA)患者免疫功能失衡与患者疾病活动程度的关系。方法选取我院类风湿免疫科确诊的RA患者90例(RA组)、健康体检志愿者60例作为对照组;检测两组对象外周血中Th17细胞、调节性T细胞(Treg)、血清γ干扰素(IFN-γ)、白细胞介素-4(IL-4)、C反应蛋白(CRP)、血沉(ESR),并分析Th17细胞、Treg、IFN-γ、IL-4与患者关节疼痛数目、类风湿关节炎病情评价(DAS28评分)的相关性。结果 RA组患者的Th17细胞、血清IFN-γ均高于对照组(P<0.05),RA组患者的Treg细胞低于对照组(P<0.05);RA组患者的血清CRP、ESR水平均高于对照组(P<0.05);DAS28评分>5.1分RA患者的Th17细胞、血清IFN-γ均高于≤5.1分的患者(P<0.05),DAS28评分>5.1分RA患者的Treg细胞低于≤5.1分的患者(P<0.05);RA患者的Th17细胞、血清IFN-γ与DAS28评分、压痛关节数目呈显著正相关(P<0.05),RA患者的Treg细胞与DAS28评分、压痛关节数目呈显著负相关(P<0.05)。结论 RA患者T细胞及免疫学因子失衡可能与患者疾病活动程度、病情严重程度有关。

Study on the relationship between immune function imbalance and disease activity in patients with rheumatoid arthritis

Objective To explore the relationship between immune dysfunction and the degree of disease activity in patients with rheumatoid arthritis(RA). Methods 90 patients with RA(RA group)and 60 healthy volunteers were selected as the control group. The peripheral blood of the two groups was tested for Th17 cells,regulatory T cells(Treg)and serum interferon-gamma.(IFN-γ),interleukin-4(IL-4),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR). The correlation between Th17 cells,Treg,IFN-γ,IL-4 and the number of joint pain in patients and therheumatoid arthritis condition assessment(DAS28 score)was analyzed. Results The levels of Th17 cells and serum IFN-γin the RA group were higher than those in the control group(P<0.05). The Treg cells in the RA group were lower than those in the control group(P<0.05). The serum CRP and ESR levels in the RA group were higher than those in the control group(P<0.05). Th17 cells and serum IFN-γin RA patients with DAS28 score >5.1 points were higher than those in DAS28≤5.1 points(P<0.05). Treg cells in RApatients with DAS28 score > 5.1 points were lower than those in DAS28≤5.1 points(P<0.05). Th17 cells and serum IFN-γin RA patients were significantly positively correlated with DAS28 score and number of tender joints(P<0.05). Treg cells in RA patients were significantly negatively correlated with DAS28 score and number of tender joints(P<0.05). Conclusion The imbalance of T cells and immunological factors in patients with RA may be related to the degree of disease activity and the severity of the disease.