【摘要】 目的 分析初发类风湿关节炎(RA)患者血淋巴细胞亚群占比及相关炎症因子(IL-6、TNF-α)表达与临床价值。方法 收集住院的30例初发类风湿关节炎患者(RA组)和30例健康人(健康对照组)的外周血，应用流式细胞术(FCM)对外周血T细胞亚群、NK细胞、B细胞进行测定，应用化学发光法对外周血TNF-α、IL-6检测，收集临床资料包括患者性别、年龄、病程、DAS28评分等进行统计分析。结果 与健康对照组相比，初发RA患者外周血淋巴亚群中CD4~+/CD8~+、CD4~+T细胞占比明显偏高(P<0.05),NK、总B细胞占比明显偏低(P<0.05),而总T、T+B+NK、CD3~+CD8~+T细胞在2组间差异无统计学意义。初发类风湿关节炎患者外周血TNF-α、IL-6、ESR、CRP与健康对照组相比，均明显偏高(P<0.05)。基于疾病活动度评分(DAS)28-CRP(3),把初发RA患者中此项评分≤5.1者归入低中度疾病活动组，将>5.1者归入高疾病活动组，得出高疾病活动组外周血淋巴亚群CD4~+T细胞、CD4~+/CD8~+以及TNF-α、IL-6、ESR、CRP表达均明显高于低中疾病活动组(P<0.05),而NK细胞明显低于低中疾病活动组(P<0.05),高疾病活动组TNF-α、IL-6、ESR、CRP明显高于低中疾病活动组(P<0.05)。结论 初发RA患者外周血CD4~+T细胞比值升高、CD4~+/CD8~+比值失衡及TNF-α、IL-6等表达增加，B细胞及NK细胞占比失衡均参与了RA发病。更多还原

【Abstract】 Objective To analyze the proportion of blood lymphocyte subsets and the expression of related inflammatory factors(IL-6,TNF-α,etc.) and their clinical values in patients with incipient rheumatoid arthritis(RA).Methods The peripheral blood of 30 hospitalized patients with RA and 30 healthy people were collected.The proportion of peripheral blood T cell subsets, NK cells and B cells were measured by FCM,and the levels of inflammatory factors such as TNF-α,IL-6 were detected by chemiluminescence method, and the clinical data including gender, age, disease duration and DAS28 score were collected for statistical analysis.Results Compared with the healthy control group, the proportion of CD4~+/CD8~+and CD4+ T cells in peripheral hemolymph subsets of patients with primary RA was significantly higher(P<0.05).And the proportion of NK and total B cells was significantly lower than that of the healthy control group(P<0.05).There were no significant differences in total T,T+B+NK,and CD3~+CD8~+T cells between the two groups.TNF-α,IL-6,ESR,CRP in the peripheral blood of patients with incipient RA were higher than those in healthy control group(P<0.05).The patients with incipient RA were divided into the low and medium disease activity group(≤5.1) and the high disease activity group(>5.1) according to disease activity score(DAS28).The CD4~+T cells and CD4~+/CD8~+ of peripheral hemolymph subgroups and the expression of TNF-α,IL-6,ESR and CRP in the high disease activity group were significantly higher than those in the low and medium disease activity group(P<0.05),and NK cells were significantly lower than those in the low-medium disease activity group(P<0.05).Inflammation factors TNF-α,IL-6,ESR,and CRP in the high disease activity group were significantly higher than those in the low and medium disease activity group(P<0.05).Conclusion In patients with incipient RA,the ratio of CD4~+The cells in peripheral blood is increased, the ratio of CD4~+/CD8~+ is out of balance and the expressions of TNF-α and IL-6 are increased.The imbalance of B cells and NK cells are all involved in the pathogenesis of RA.更多还原