类风湿关节炎患者外周血滤泡辅助性T淋巴细胞百分率的变化及意义

摘要

Objective To investigate the change and significance of follicular helper T cells (Tfh) percentage in the peripheral blood of the patients with rheumatoid arthritis (RA).Methods The RA patients treated in this hospital from September to November 2016 were selected and divided into the RA active group and RA stable group,35 cases in each group.Contemporaneous 35 individuals undergoing physical examination were selected as the healthy control group.The percentage of peripheral blood CD4+ CXCR5+ ICOS+ Tfh cells was detected by flow cytometry.The correlations between the percentage of peripheral blood Tfh cells in RA patients with the RA disease activity score 28 (DAS28),anti-CCP antibody and rheumatoid factor(RF) levels were analyzed.Results The percentage of peripheral blood Tfh cells in the RA active group was (0.84±0.16) ％,which was significantly higher than (0.64±0.15)％ in the RA stable group and (0.56±0.14)％ in the healthy control group,the difference was statistically significant (P＜0.01);moreover the percentage of peripheral blood Tfh cells in the RA stable group was also higher than that in the healthy control group (P＜0.05).The percentage of peripheral blood Tfh cells in RA patients had significantly positive correlation with DAS28 score and anti-CCP antibody level (r=0.355,0.324;P＜0.01),and had no correlation with the RF level (r=0.205,P＞0.05).Conclusion The percentage increase of peripheral blood Tfh cells in the patients with RA might be related with the pathogenesis and development of RA.%目的 探讨滤泡辅助性T淋巴细胞(Tfh)百分率在类风湿关节炎(RA)患者外周血中的变化及意义.方法 选取该院2016年9-11月收治的RA患者,分为RA活动组与RA稳定组,各35例.另选取同期行健康体检者35例作为健康对照组.用流式细胞术检测受试者外周血CD4+ CXCR5+ ICOS+ Tfh细胞的百分率,分析RA患者外周血Tfh细胞百分率与28个关节疾病活动度评分(DAS28)、抗环瓜氨酸肽(CCP)抗体及类风湿因子(RF)水平的相关性.结果 RA活动组外周血Tfh细胞百分率[(0.84±0.16)％]明显高于RA稳定组[(0.64±0.15)％]及健康对照组[(0.56±0.14)％],差异均有统计学意义(P＜0.01);且RA稳定组亦高于健康对照组(P＜0.05).RA患者外周血Tfh细胞百分率与DAS28及抗CCP抗体水平均呈明显正相关(r=0.355、0.324,P＜0.01),与RF水平无明显相关性(r=0.205,P＞0.05).结论 外周血中Tfh细胞百分率的增加可能与RA的发生、发展有关.