强直性脊柱炎患者外周血T细胞亚群表达的临床意义

目的 探讨强直性脊柱炎(AS)患者外周血中T细胞亚群分布以及在AS细胞免疫中所发挥的作用.方法 采用流式细胞技术检测30例未经治疗的活动期AS患者及30例健康对照人群外周血中的CD4+、CD8+T细胞亚群,并探讨其与Bath AS功能指数(BASFI)、Bath AS测量指数(BASMI)、病程、年龄及血沉(ESR)、超敏C反应蛋白(hs-CRP)的相关性.结果 AS患者CD4+水平和CD4+/CD8+比值分别为(29.24±9.22)%和0.96±0.49,较正常对照组的(40.09±6.86)%和1.70±0.67显著降低(P均＜0.01);CD8+水平为(32.91±6.86)%,较正常对照组的(25.60±5.97)%明显增高(P＜0.01);AS患者外周血CD4+水平与BASMI呈负相关(r=-0.479,P＜0.01).CD8+与血沉、hs-CRP、BASFI、BASMI呈正相关(r值分别为0.373、0.430、0.462、0.530,P均＜0.05).CD4+/CD8+比值与hs-CRP、BASFI、BASMI呈负相关(r值分别为-0.465、-0.473、-0.426,P均＜0.05).CD4+、CD8+、CD4+/CD8+比值与AS患者的年龄、病程均无明显相关性(P均＞0.05).结论 AS患者外周血存在T淋巴细胞亚群紊乱,其水平与AS的严重程度、活动性有关,提示T细胞亚群失衡在AS的发生发展中具有重要意义.

Clinical significance and expression of T cell subsets in peripheral blood from patients with ankylosing spondylitis

Objecfive To study T cell subsets distribution in peripheral blood from patients with ankylosing spondylitis(AS)and the role of cell immunity in AS.Methods 30 patients with untreated active phase AS and 30 healthy volunteers were enrolled.The expression of CD4+ and CD8+ T cell subsets were evaluated by flow eytome try.The correlation among T cell subsets and Bath AS function index(BASFI).Bath AS measurement index(BASMI),course of disease,age,ESR,hyper-sensitive C-reactive protein (hs-CRP) were analyzed.Results The level of CD4+ T cell and CD4/CD8+ratio were significantly lower than that of healthy volunteers[(29.24±9.22)% vs.(40.09±6.86) %,(0.96±0.49 ) vs.(1.70±0.67 ),P ＜ 0.01 ],and CD8+ T cell were significantly higher than that of healthy volunteers [(32.91±6.86) % vs.(25.60± 5.97 ) %,P ＜ 0.01 ].The level of CD4+ T cell subsets in peripheral blood of AS patients was negatively correlated with BASMI (r =-0.479,P ＜ 0.01 ),and CD8+ T cell subsets were positively correlated with ESR,hs-CRP,BASFI and BASMI ( r = 0.373,0.430,0.462,0.530,P ＜0.05 ).The ratio of CD4+/CD8+ was negatively correlated with hs-CRP,BASFI and BASMI (r = -0.465,- 0.473,- 0.426,P ＜ 0.05 ).CD4+,CD8+,ratio of CD4/CD8 were not significantly correlated with age and course of disease in patients with AS.Conclusion T cell subsets are significantly abnormal in peripheral blood of patients with AS,and the imbalance degree of T cell is correlated with severity and activity of AS,suggesting that T cell subsets imbalance plays an important role in the pathologensis of AS.