• 主题
高级搜索  >
历史搜索 清空历史
您现在的位置：首页> 中文期刊>内科学>医药卫生>中华风湿病学杂志

中华风湿病学杂志

中华风湿病学杂志

北大核心

CSCD

CSTPCD

Chinese Journal of Rheumatology
中国科学技术协会主管，中华医学会主办。本刊以广大风湿病学医师为主要读者对象，报道风湿病学领域领先的科研成果和临床诊疗经验，以及对风湿病学临床有指导作用、且与风湿病学临床密切结合的基础理论研究。本刊设有专论、论著、基础研究、临床研究、短篇论著、综述、讲座、病例报告、临床病理（病例）讨论、国内外学术动态等栏目。
  • 发文量：5352
  • 被引量：2582
  • H指数：3
  • 开始收录时间：1997,2(1)
  • CNKI综合因子：0.437
  • 维普期刊影响因子： 0.631
  • 万方期刊影响因子：0.93
  • 创刊时间：1997
  • 国内刊号/CN：14-1217/R
    国际刊号/ISSN：1007-7480
  • 发行周期：月刊
    邮发代号：22-153
  • 主管单位：中国科学技术协会
    主办单位：中华医学会
中华风湿病学杂志-联系信息
  • 主编：-
  • 电话：0351-7553295 7553182
  • 邮箱：cmafsb@163.com
  • 地址：山西省太原市东华门23号
  • 邮编：030001
中华风湿病学杂志-获奖情况
  • 暂无获奖信息
  • 收录汇总
  • 刊内文献检索
  • 投稿信息

刊期浏览

相关中文期刊

相关中文会议

相关外文期刊

相关外文会议

最新期刊

热门期刊

中华风湿病学杂志 >2022年第1期

学科

年度

全选（0）
排序：
共4384条结果
  • 摘要：Objective To study the expression of peripheral blood lymphocyte subsets in psoriatic arthritis (PsA) patients and the short-term efficacy of low doses of interleukin-2 (IL-2). Methods Ninety-five patients with PsA were enrolled as study subjects and 106 healthy people as control group. On the basis of conventional treatment, a total of 22 PsA patients were randomly selected and treated with low dose IL-2 (5 ×105 U/d, continuously used for 5 days, IH), and the disease condition and lymphocyte changes were observed. Flow cytometry was used to detect the absolute count of T subsets dominated by regulatory T cell(Treg) and T helper cell 17(Th17). Wilcoxon rank sum test, χ2 test and Spearman correlation analysis were used for statistical analysis. Results The absolute number of Th17 cells of PsA patients [7.2 (4.0, 12.8) cells/μl] was higher than that of the control group [5.9(4.0, 8.6) cells/μl] (Z=-1.997, P=0.046), the number of Treg cells [25 (17, 36) cells/μl] decreased compared with the control group [30 (23, 40) cells/μl] (Z=-2.957, Z=0.003), T/Treg [50 (36), 76)], B/Treg [7.6 (5.4, 11.5)], CD4+T/Treg [27 (21, 42)], CD8+T/Treg [20 (12, 30)], Th17/Treg [0.34(0.13, 0.51)], Th1/Treg [4.4(2.3, 7.2)], Th2/Treg [0.34(0.20, 0.53)], compared with control group T/Treg [40 (32, 54)], B/Treg [6.5 (4.2, 8.1)], CD4+T/Treg [20 (17, 25)], CD8+T/Treg [16 (11, 24)], Th17/Treg [0.19 (0.13, 0.31)], Th1/Treg [3.5 (1.8, 5.8)], Th2/Treg [0.24 (0.15, 0.39)] were significantly increased (Z=-3.365, -3.217,-5.285, -2.097, -1.69, -1.482, -2.304, P<0.05). Treg cells were negatively correlated with disease activity indexes TJC (r=-0.213, P=0.038), VAS (r=-0.299, P=0.003), PHGA (r=-0.287, P=0.005), DLQI (r=-0.208, P=0.043). Th17 cells increased from [6.3 (2.3, 11.5) cells/μl] to [11 (7, 20) cells/μl, Z=-2.808, P=0.005] after low-dose IL-2 treatment, Treg cells increased from [27 (15, 30) cells/μl] to [71 (37, 98) cells/μl, Z=-3.945, P<0.01]. Because the growth rate of Treg was much higher than Th17, Th17/Treg [before IL-2 treatment: 0.26 (0.11, 0.44), after IL-2 treatment: 0.14 (0.1, 0.35)] returned back to the normal range. After the treatment with IL-2, the patient's activity indicators were significantly improved, and there were no reversible adverse reactions. Conclusion The reduction of Treg cells may be involved in the occurrence and devel-opment of PsA. Low-dose IL-2 treatment can effectively promote the proliferation of Treg cells and the recovery of Th17/Treg balance, which is conducive to the improvement of the condition and good safety.%目的 研究PsA患者外周血淋巴细胞亚群的表达情况,以及小剂量IL-2短期疗效分析.方法 收集PsA患者95例为研究对象,健康人106名为对照组.采用简单随机法选取22例PsA患者在传统治疗(NSAIDs和/或DMARDs)基础上,试验性给予小剂量IL-2(50万U/d,连用5 d,皮下注射)治疗,观察病情及淋巴细胞亚群变化.流式细胞术检测以CD4+CD25+Foxp3+调节性T细胞、辅助性T细胞17(Th17)为主的T细胞亚群绝对计数.采用Wilcoxon秩和检验、 χ2检验、Spearman相关性分析进行统计分析.结果 PsA患者外周血Th17细胞绝对数[7.2(4.0,12.8)个/μl]较对照组[5.9(4.0,8.6)个/μl]升高(Z=-1.997,P=0.046),调节性T细胞数[25(17,36)个/μl]较对照组[30(23,40)个/μl]下降(Z=-2.957,P=0.003),T细胞/调节性T细胞[50(36,76)]、B细胞/调节性T细胞[7.6(5.4,11.5)]、CD4+T/调节性T细胞[27(21,42)]、CD8+T/调节性T细胞[20(12,30)]、Th17/调节性T细胞[0.34(0.13,0.51)]、Th1/调节性T细胞[4.4(2.3,7.2)]、Th2/调节性T细胞[0.34(0.20,0.53)]较对照组T细胞/调节性T细胞[40(32,54)]、B细胞/调节性T细胞[6.5(4.2,8.1)]、CD4+T/调节性T细胞[20(17,25)]、CD8+T/调节性T细胞[16(11,24)]、Th1/调节性T细胞[0.19(0.13,0.31)]、Th1/调节性T细胞[3.5(1.8,5.8)]、Th17/调节性T细胞[0.24(0.15,0.39)]均显著升高(Z=-3.365,-3.217,-5.285,-2.097,-1.69,-1.482,-2.808,-2.304,P<0.05).调节性T细胞与病情活动指标压痛关节数(TJC)[r=-0.213,P=0.038]、疼痛视觉模拟评分(VAS)[r=-0.299,P=0.003]、医生对疾病活动性的总体评分(PHGA)[r=-0.287,P=0.005]、皮肤病生活质量指数(DLQI)[r=-0.208,P=0.043]呈负相关.小剂量IL-2治疗后Th17细胞由[6.3(2.3,11.5)个/μl]增至[10.1(7.0,20.3)个/μl,Z=-2.808,P=0.005];调节性T细胞由[27(15,30)个/μl]增至[71(37,98)个/μl,Z=-3.945,P<0.01],因调节性T细胞的增长幅度远大于Th17,Th17/调节性T细胞[IL-2治疗前:0.26(0.11,0.44),IL-2治疗后:0.14(0.10,0.35)]回降至正常范围.小剂量IL-2治疗后病情活动指标明显改善,且无不可逆的不良反应.结论 调节性T细胞的减少可能参与了PsA的发生、发展,小剂量IL-2治疗可有效促进调节性T细胞的增殖以及Th17/调节性T细胞平衡的恢复,有利于改善病情且安全性良好.
  • 摘要：Objective To investigate the change and significance of regulatory T cells (Tregs) in peripheral blood in patients with acute and chronic gout. Methods Flow cytometry was used to detect the ratio of Tregs in peripheral blood of healthy controls, patients with acute gout and patients with chronic gout. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of transforming growth factor (TGF)-βand interleukin (IL)-1βin plasma. Then, statistical analysis was conducted to analyze the changes and significance in different stages of gout, such as F test, Kruskal-Walls H test, q test and Pearson and Spearman correlation analysis. Results ① The percentage of CD4+CD25+Foxp+Treg/CD4+ T cells in peripheral blood was (1.22±0.27)％ in control group. While in patients with acute gout, it was (1.51±0.43)％, and (0.47±0.26)％in patients with chronic gout. There were statistical significant difference among the three groups ( F=101.39, P<0.05). The percentage of Tregs in acute gout group was significantly higher than that in control group and chronic gout group, while it was significantly lower in chronic gout group than in control group ( P<0.05). ②The concentration of TGF-β in plasma was (170 ±12) ng/L in control group, (214 ±77) ng/L in patients with acute gout and (179±21) ng/L in patients with chronic gout, the difference was statistically-significant (F=6.20, P<0.05). The concentration of TGF-β in plasma in acute gout group was significantly higher than the control group and chronic gout group, the difference was statistically significant (P<0.05), while the difference between chronic gout group and the control group was not statistically significant ( P>0.05). ③The con-centration of IL-1β in plasma in the control group was (4.8 ±1.3) ng/L, while that in patients with acute and chronic gout was (10.1±8.5) ng/L and (11.50±12.57) ng/L respectively, the difference between these three groupswas stati-sticallysignificant (P<0.05). The concentration of IL-1β in plasma in acute gout group and chronic gout group wassignificantly higher than that in the control group, the difference was statistical significant ( P<0.05). There was no significant difference between acute gout and chronic gout (P>0.05) patients. ④ The percentage of Tregs in peripheral blood of gout patients was negatively correlated with the duration of disease and the number of gout attacks within six months (duration of disease: r =-0.381, P <0.01 ; number of gout attacks: r=-0.518, P<0.01). But there wasno significant correlation to the concentration of TGF-β and IL-1β. Conclusion Tregsincreasesin acute gout and participate in the alleviation of gout inflammation, while the persistence of chronic gout may be related to the decrease of Tregs. Therefore, Tregs play an important regulatory role in the transformation of acute and chronic gout.%目的 探讨调节性T细胞(Treg)在急、慢性痛风患者外周血中的变化及意义.方法 采用流式细胞术检测健康对照、 急性痛风和慢性痛风患者外周血调节性T细胞的比值,ELISA方法检测血浆中TGF-β、IL-1β浓度,采用F检验、Kruskal-Walls H检验、q检验以及Pearson、Spearman相关分析等方法分析它们在痛风不同阶段的变化及意义.结果 ①健康对照组外周血CD4+CD25+Foxp+调节性T细胞/CD4+T细胞百分率为(1.22±0.27)％、急性痛风组为(1.51±0.43)％、慢性痛风组为(0.47±0.26)％,3组间差异有统计学意义(F=101.39,P<0.05),急性痛风较健康对照组、慢性痛风组调节性T细胞百分率均升高,慢性痛风较健康对照组降低,差异均有统计学意义(P均<0.01).②健康对照组血浆TGF-β浓度为(170±12)ng/L、急性痛风组为(214±77)ng/L、慢性痛风组为(179±21)ng/L,3组间差异有统计学意义(F=6.20,P<0.05).急性痛风较健康对照组、慢性痛风组均升高,差异有统计学意义(P=0.003,P<0.05),慢性痛风组与健康对照组间差异无统计学意义(P>0.05).③健康对照组血清IL-1β浓度为(4.8±1.3)ng/L、急性痛风组为(10.1±8.5)ng/L、慢性痛风组为(11.5±12.6)ng/L,3组间差异有统计学意义(χ2=7.54,P<0.05).急性痛风、慢性痛风较健康对照组均升高,差异有统计学意义(Z=2.76,P<0.05;Z=2.29,P<0.05),急性痛风与慢性痛风组间差异无统计学意义(Z=0.54,P>0.05).④痛风患者外周血调节性T细胞百分率与病程、6个月内发病次数均呈负相关(病程:r=-0.381,P<0.05;发病次数:r=-0.518,P<0.01),与血浆TGF-β、IL-1β浓度均无相关.结论 调节性T细胞在急性痛风中升高,参与了痛风炎症缓解;在慢性痛风中降低,可能与痛风迁延不愈有关.调节性T细胞在急、慢性痛风转换中起重要调控作用.
  • 摘要：肌骨超声是RA重要的诊断工具之一,可以有效探查滑膜炎、腱鞘炎等病变,滑膜炎一直是研究的热点,而关于腱鞘炎的临床研究却并不多见.事实上,腱鞘炎可见于RA病程的不同时期,且有助于RA早期诊断、病情随访,甚至预测疾病进展.本文通过总结目前国内外学者对超声下腱鞘炎的相关研究,旨在强调腱鞘炎在RA中的价值,为今后RA患者的诊治提供更多的参考.
  • 摘要：Objective To determine the CD4+CD25+Foxp3+T regulatory (Treg) cell levels in peripheral blood (PB) of patients with autoimmune diseases (AID) and age-and sex-matched healthy controls. Methods Clinical data and laboratory examinations of AID cases (n=1561) and healthy controls (n=196) were enrolled. The levels of PB Treg cells, other T lymphocyte subsets [total T, CD4+T, CD8+T, T helper1 (Th1), T helper 2 (Th2), and T helper17(Th17) cells] and clinical indicators, laboratory test results were analyzed retro-spectively. Data were analyzed by t test, Mann-Whitney U test,χ2 test and Spearman correlation analysis. Results ①The absolute counts of Treg [22.9(18.31, 36.47) vs 30.24(21.85, 41.34), Z=-3.974, P<0.01], total T (Z=-4.234, P<0.01), CD8+T (Z=-3.801, P<0.01), Th17 (Z=-3.740, P<0.01) cells in PB of patients with AID were significantly lower than those of healthy controls, the levels of CD4+T/Treg (Z=-3.366, P=0.001), Th1/Treg (Z=-3.213, P=0.001) and Th2/Treg (Z=-2.490, P=0.013) in PB of AID patients were higher than those of healthy controls.② The levels of inflammatory indicators were associated with numbers of T lymphocyte subsets. ③ The levels of Treg (Z=-3.624, P<0.01), total T (Z=-2.954, P=0.009), CD4+T (Z=-3.005, P=0.003), Th2 (Z=-1.896, P=0.049) cells in PB of the patients who had been treated with hormones and/or biological or non-biological disease-modifying anti-rheumatic drugs (DMARDs) were significantly lower while the levels of total T/Treg (Z=-2.460, P=0.014), CD8+T/Treg (Z=-3.197, P=0.001) in PB were higher than those of the primary treatment patients. ④ The levels of Treg (Z=-7.105, P<0.01), total T (Z=-2.954, P<0.01), CD4+T (Z=-6.909, P<0.01), Th1 (Z=-4.875, P<0.01), Th2 (Z=-5.751, P<0.01), Th17 (Z=-5.121, P<0.01) cells in PB of the patients with important organs involvement were lower while the ratios of total T/Treg (Z=-4.500, P<0.01), CD8+T/Treg (Z=-5.925, P<0.01) were higher than those non-organ involvement patients. ⑤ The absolute counts levels of T lymphocyte subsets in the AID patients were not significantly correlated with whether there was a single AID and/or multiple AID overlaps. Conclusion The absolute number of peripheral Treg cells decreases significantly in AID, and is correlated with inflammatory indicators. Patients with retreated and organ involve-ment have fewer Treg cells. Our results suggest that Treg cells may play an important role in the pathogenesis of AID.%目的 观察自身免疫病(AID)患者外周血CD4+CD25+Foxp3+调节性T细胞的变化并探讨其意义.方法 收集资料完整的AID患者1561例及健康对照组196名,对外周血CD4+CD25+Foxp3+调节性T细胞绝对计数及其与其他T细胞亚群[总T细胞、CD4+T细胞、T辅助细胞(Th)1、Th2、Th17、CD8+T细胞的比值进行分析,并进行T细胞亚群与炎性指标的相关性分析.采用独立样本t检验、Mann-Whitney U检验、χ2检验和Spearman相关性分析进行统计学分析.结果 ①AID组外周血调节性T细胞[22.9(18.31,36.47)与30.24(21.85,41.34),Z=-3.974,P<0.01]、总T细胞(Z=-4.234,P<0.01)、CD8+T细胞(Z=-3.801,P<0.01)、Th17(Z=-3.740,P<0.01)细胞绝对计数水平低于健康对照组,CD4+T细胞/调节性T细胞(Z=-3.366,P=0.001)、Th1/调节性T细胞(Z=-3.213,P=0.001)、Th2/调节性T细胞(Z=-2.490,P=0.013)水平高于健康对照组.②AID患者外周血T细胞亚群与ESR、CRP、补体C3、C4、病程等存在相关性.③复治患者调节性T细胞(Z=-3.624,P<0.01)、总T细胞(Z=-2.954,P=0.009)、CD4+T细胞(Z=-3.005,P=0.003)、Th2(Z=-1.896,P=0.049)细胞绝对计数水平低于初治患者,总T细胞/调节性T细胞(Z=-2.460,P=0.014)、CD8+T细胞/调节性T细胞(Z=-3.197,P=0.001)水平高于初治患者.④脏器受累患者调节性T细胞(Z=-7.105,P<0.01)、总T细胞(Z=-4.892,P<0.01)、CD4+T细胞(Z=-6.909,P<0.01)、Th1(Z=-4.875,P<0.01)、Th2(Z=-5.751,P<0.01)、Th17(Z=-5.121,P<0.01)细胞绝对计数水平低于非脏器受累患者,总T细胞/调节性T细胞(Z=-4.500,P<0.01)、CD8+T细胞/调节性T细胞(Z=-5.925,P<0.01)水平高于非脏器受累患者.⑤AID患者T细胞亚群绝对计数水平与是否为单一AID和(或)为多种AID重叠无明显相关.结论 AID患者外周血调节性T细胞水平明显下降,且与炎性指标存在相关性,复治患者较初治患者调节性T细胞进一步降低,脏器受累者调节性T细胞水平更低,表明调节性T细胞在AID的发病机制中可能起重要的作用.
  • 摘要：目的 探讨多发性硬化(MS)患者外周血辅助性T细胞17(Th17)和Th17相关细胞因子IL-17和IL-23及调节性T细胞的水平.方法 急性发作复发缓解型MS患者(RRMS)组20例及对照组20名,分析Th17和调节性T细胞比率及IL-17和IL-23水平,比较2组Th17、调节性T细胞、IL-17和IL-23表达水平;给予甲泼尼龙治疗,比较治疗前后RRMS组Th17、调节性T细胞、IL-17和IL-23水平,并结合扩展残疾状况评分量表(EDSS)评分、头颅MRI增强病灶数目对RRMS组进行病情评估,采用IBM SPSS 17.0软件对数据进行统计分析.RRMS组与对照组计量资料比较采用独立样本t检验,计数资料比较采用χ2检验;RRMS组治疗前、治疗后的比较采用配对样本t检验;RRMS组治疗前变量采用Pearson相关分析.结果 RRMS组外周血中Th17细胞高于对照组[(2.10±0.45)％与(1.09±0.20)％;t=9.130,P<0.01],IL-17和IL-23高于对照组(IL-17:t=19.843,P<0.01;IL-23:t=22.747,P<0.01),RRMS组调节性T细胞低于对照组[(1.33±0.30)％与(2.52±0.30)％;t=12.422,P<0.01].Th17、IL-17与EDSS评分呈正相关(Th17:r=0.458,P<0.05;IL-17:r=0.480,P<0.05),IL-23与EDSS评分无明显相关性(r=0.368,P>0.05),Th17、IL-17、IL-23与头颅MRI增强数呈正相关(r=0.446,P<0.05;IL-17:r=0.544,P<0.05;IL-23:r=0.461,P<0.05).给予甲泼尼龙治疗,与治疗前相比,治疗结束后,RRMS组Th17、IL-17、IL-23降低(Th17:t=5.747,P<0.01;IL-17:t=9.967,P<0.01;IL-23:t=14.697,P<0.01),调节性T细胞增高(t=10.050,P<0.01).治疗后与对照组比较,RRMS组Th17、IL-17及IL-23仍高于对照组(Th17:t=6.889,P<0.01;IL-17:t=7.185,P<0.01;IL-23:t=13.284,P<0.01),调节性T细胞仍低于对照组(t=7.622,P<0.01).RRMS组治疗前后,EDSS评分降低(t=6.190,P<0.01),头颅MRI增强数目差异无统计学意义(t=1.453,P>0.05).结论 Th17/调节性T细胞表达失衡及Th17相关细胞因子IL-17和IL-23的高表达参与了MS的病理过程,可能作为治疗MS的新靶点.%Objective To investigate the levels of T helper cell 17 (Th17), Th17-related cytokines in-terleukin 17 (IL-17) and interleukin 23 (IL-23) and regulatory T cell (Treg) in relapsing remitting multiple sclerosis (RRMS). Methods In a case-control study, plasma was collected from RRMS patients (n=20) and healthy subjects as control group (n=20). The percentages of Th17 and Treg cells and the levels of IL-17 and IL-23 were tested. The levels of Th17, Treg, IL-17 and IL-23 of the two groups were compared. Patients were treated with methylprednisolone. The levels of Th17, Treg, IL-17 and IL-23 of multiple sclerosis (MS) patients b efore and after treatment were compared. Expanded disability status scale (EDSS) score and the number of Gd-enhancing lesions were evaluated in the case group. Statistical analysis was made by body mass index (IBM) statistical program for social sciences (SPSS) 17.0 software. Independent sample t test was conducted to compare the measurement data of the case group and the healthy control group, and enumeration data were compared by χ2 test; paired sample t test was performed to compare the data of the case group before and after treatment; Pearson correlation analysis was made forthe variables of the MS group before treatment. Results In the RRMS group, the percentage of Th17 cells in peripheral blood was significantly higher than the control group [(2.10±0.45)％vs (1.09±0.20)％](t=9.130, P<0.01), the levels of Th17-related cytokines IL-17 and IL-23 were remarkably higher than the control group (IL-17:t=19.843, P<0.01;IL-23:t=22.747, P<0.01), and the percentage of Treg cells was significantly lower than the control group [(1.33 ±0.30)％vs (2.52±0.30)％], (t=12.422, P<0.01). The levels of Th17 and IL-17 were positively associated with EDSS score (Th17: r=0.458, P<0.05; IL-17: r=0.480, P<0.05), there was no significant-correlation between the level of IL-23 and EDSS score (r=0.368, P>0.05), and Th17, IL-17 and IL-23 were positively correlated with the number of Gd-enhancing lesions (Th17: r=0.446, P<0.05; IL-17: r=0.544, P<0.05; IL-23: r=0.461, P<0.05). The levels of Th17, IL-17 and IL-23 in the RRMS group after the treatment with methylprednisolone were obviously decreased than before treatment (Th17: t=5.747, P<0.01; IL-17: t=9.967, P<0.01; IL-23: t=14.697, P<0.01), while that of Treg was apparently increased (t=10.050, P<0.01). Compared with the control group, the levels of Th17, IL-17 and IL-23 in the RRMS group after treatment were higher (Th17: t=6.889, P<0.01;IL-17:t=7.185, P<0.01;IL-23:t=13.284, P<0.01), and the percentage of Treg was lower (t=7.622, P<0.01). EDSS score of the RRMS group after treatment was remarkably decreased than before treatment(t=6.190, P<0.01), but the number of Gd-enhanced lesions after treatment was no significantiy changed (t=1.453, P>0.05). Conclusion Th17/Treg expression imbalance and Th17-related cytokines IL-17, IL-23 may participate in the pathological process of MS, and they might be therapeutic target for MS.
  • 摘要：RA是一种自身免疫病,生物制剂的应用是治疗RA的重大突破和进展,近年国内首个转基因工程产生的每月一次全人源抗TNF-α单克隆抗体戈利木单抗的问世,满足了医患的临床需求,也有效推进RA的治疗进展.本文就戈利木单抗的药理特性、治疗RA的临床评价及安全性等方面进行综述.
  • 摘要：报道1例SS合并获得性血友病A(AHA)患者,为62岁女性,先后2次出现自发性或轻微碰撞后的大腿部血肿.经行自身抗体等检查诊断SS,凝血常规示APTT明显延长.进一步查凝血因子Ⅷ活性显著下降,凝血因子Ⅷ抑制物阳性,诊断为AHA.经应用大剂量激素联合环孢素等治疗后,病情好转、稳定.临床上遇到不明原因出血的患者,尤其是有自身免疫性疾病基础者,需要考虑到AHA的可能.对于CTD继发AHA的治疗,激素联合免疫抑制剂可能较单用激素能取得更好的疗效.
  • 摘要：自身免疫病是指机体对自身正常组织产生高滴度自身抗体和(或)自身反应性淋巴细胞,导致损伤和功能障碍的一组疾病.糖皮质激素具有显著的抗炎及免疫抑制作用,是治疗自身免疫病的有力武器;但长期、大量应用糖皮质激素不可避免地会给患者带来诸多不良反应,严重影响患者的生活质量.因此,深入探索减少糖皮质激素的脱靶作用具有重要的意义.脂质体是近年来广受关注的纳米载体之一,具有主动靶向和被动靶向的特点,在药物递送中扮演重要角色.目前已有研究发现包载糖皮质激素的脂质体可以实现靶向递送,增加疗效,在一定程度上减少糖皮质激素的不良反应.本文就糖皮质激素脂质体在3种常见自身免疫病治疗中发挥的作用进行综述.
  • 摘要：风湿免疫性疾病是由于免疫系统异常,损害不同系统或器官,临床表现复杂的一类疾病.然而,目前诊断和治疗上通常主要依靠临床经验,而不是基于免疫学机制.尽管基础免疫学对免疫性疾病的发病机制和治疗进行了大量的基础研究,但有关免疫学诊断标准和治疗的临床研究仍然缺乏.因此,需要进行更多的临床免疫研究,阐明免疫细胞、抗体、细胞因子的临床意义,并进一步建立诊断和治疗的标准,或者明确不良反应.为推动我国临床免疫学的发展,需要进一步加强风湿病学专家、检验学专家和免疫学、药理学专家之间密切的合作和交流,促进学科融合.
  • 摘要：目的 分析铁蛋白、糖类抗原(CA)125、CA153、LDH、白蛋白与原发性干燥综合征合并间质性肺炎(Pss-IP)的进展和预后的关系.方法 回顾性分析从2011—2017年Pss患者527例,依据肺影像学特点及临床特征进行分组,采用Mann-Whitney U秩和检验分析铁蛋白、CA125、CA153、LDH、白蛋白在各组水平差异,采用Logistic回归对Pss-IP进展的危险因素进行分析.结果 ①527例Pss患者中诊断有Pss-IP者206例(39.1％);与无间质性肺炎(Pss-N-IP)患者(321例)比较:Pss-IP患者的铁蛋白、CA125、CA153、LDH相对较高[189(116,380)ng/ml与138(75,258)ng/ml,Z=-3.777,P<0.05;19(12,36)U/ml与12(9,19)U/ml,Z=-5.974,P<0.05;22(12,34)U/ml与9(6,14)U/ml,Z=-4.582,P<0.05;206(165,258)U/L与161(139,195)U/L,Z=-8.770,P<0.05],而白蛋白较低[34(31,37)g/L与36(34,39)g/L,Z=5.210,P<0.05].②将Pss-IP患者结合肺部影像学特点分为Pss-IP进展组(46例)和Pss-IP稳定组(60例),与Pss-IP稳定组相比,Pss-IP进展组铁蛋白较高[254(129,693)ng/ml与161(104,259)ng/ml,Z=-2.437,P<0.05].③Logistic回归分析提示铁蛋白与Pss-IP的进展有一定相关性(OR=1.002).结论 铁蛋白、CA125、CA153、LDH、白蛋白与Pss-IP具有相关性;铁蛋白与Pss-IP的进展具有相关性,是Pss-IP的进展的危险因素.%Objective To analyze the relationship between ferritin, carbohydrate antigen (CA)125, CA153, lactic dehydrogenase (LDH), albumin and progression and prognosis of Sj?gren's syndrome with inter-stitial pneumonitis (pSS-IP). Methods Five hundred and twenty-seven primary pSS patients from 2011 to 2017 were analyzed retro-spectively. According to the lung imaging and clinical features, they were divided into groups. The differences of ferritin, CA125, CA153, LDH and albumin (ALB) levels in each group were analyzed by Mann-Whitney U test. Logistic regression was used to analyze the risk factors of pSS complicated with interstitial pneumonitis. Results ① Among the 527 pSS patients, 206 (39.1％) were diagnosed with IP. Compared with 321 patients without interstitial pneumonitis (pSS-N-IP), ferritin, CA125, CA153 and LDH in pSS-IP were relatively higher [189(116, 380) ng/ml vs 138(75, 258) ng/ml, Z=-3.777, P<0.05;19(12, 36) U/ml vs 12(9, 19) U/ml, Z=-5.974, P<0.05;22(12, 34) U/ml vs 9(6, 14) U/ml, Z=-4.582, P<0.05;206(165, 258) U/L vs 161(139, 195) U/L, Z=-8.770, P<0.05], while albumin was lower [34(31, 37) g/L vs 36(34, 39) g/L, Z=5.210, P<0.05]. ② pSS-IP were divided into pSS-IP progression group (46 cases) and pSS-IP stable group (60 cases) according to their lung imaging characteristics. Compared with pSS-IP stabilization group, pSS-IP progression group had higher ferritin [254(129, 693) ng/ml vs 161(104, 259) ng/ml, Z=-2.437, P<0.05]. ③ Logistic regres-sion analysis showed that there was correlation between ferritin and the progress of pSS-IP (OR=1.002). Conclusion Ferritin, CA125, CA153, LDH, albumin are related to pSS-IP. Ferritin isrelated to the progress of pSS-IP, and is a risk factor for the progress of pSS-IP.
  • 摘要：目的 了解RA患者中微RNA(miRNA)的表达情况及与临床表现、实验室检查、病情活动性、细胞因子水平以及治疗反应的相关性.方法 选取2015年10月至12月就诊于内蒙古医科大学附属医院风湿免疫科的初诊RA患者38例,实时荧光定量PCR检测38例初诊RA患者基线期、38名健康对照组及治疗后3个月RA患者PBMCs中miRNA表达量.计数资料采用χ2检验或Fisher确切概率法.计量资料采用独立样本t检验或配对t检验.Levene法检验方差齐性.结果 ①基线期RA患者组miR-125b(1.55±0.24),miR-155(3.1±0.5),miR-346(650±51),miR-223-3p(1.26±0.18),miR-146a-5p(2.39±0.25)表达高于健康对照组(0.84±0.16,1.4±0.5,304±101,0.58±0.11,1.09±0.27,t=15.36,18.60,18.77,19.67,21.66;P<0.05),miR-21-5p(0.91±0.09)表达低于健康对照组(1.52±0.21,t=-16.029,P<0.05),而miR-146a-3p,miR-21-3p,miR-223-5p表达在2组间差异并无统计学意义.②miRNA表达水平与RA临床表现、实验室检查、病情活动性和细胞因子包括IL-1β,IL-6,IL-17a,IL-23和TNF-α水平相关性进行相关性分析,发现miR-146a、miR-155的表达水平与RA病情活动度评分呈正相关(与DAS28、CDAS、SDAS评分的Pearson相关系数分别为0.877,0.877,0.877;0.817,0.817,0.817;P均<0.05);miR-21与RA病情活动度评分、炎性细胞因子呈负相关.③治疗后RA患者关节压痛、肿胀等临床症状、实验室指标及超声影像学检查均改善(P<0.05),RA患者miRNA的表达均减低(P<0.05),而miR-21表达则显著性增加(P<0.05).结论 MiR-125b,miR-21,miR-155,miR-346,miR-223,miR-146a在RA患者中差异化表达,且与病情活动和治疗反应相关,提示miRNA的检测可作为RA病情活动的判断指标,用于监测治疗效果.%Objective To investigate the correlation between miRNAs and clinical manifestations, laboratory examinations, serum cytokines and disease activity scores in rheumatoid arthritis (RA). Methods Thirty-eightnewly diagnosed RA patients who visited the department of Rheumatology of Inner Mongolia Medical Affiliated Hospital from October 2015 to December 2015 were enrolled in the study. Thirty-eight age and sex matched healthy volunteers were enrolled as the control group. MiR-125b, miR-21, miR-155, miR-346, miR-223, miR-146a were tested by real-time fluorescence quantitative polymerase chain reaction (real-time PCR). Datawere collected at the baseline and 3 weeks after the study. Solutions statistical package for the social sciences (SPSS) 20.0 version was usedfor statistical analysis. Data were analyzed using t test or χ2 test and Pearson test was used for correlation analysis.Levene method was used to test homogeneity of variance. Results MiR-125b (1.55±0.24), miR-155 (3.1±0.5), miR-346 (650±51), miR-223-3p (1.26±0.18), miR-146a-5p (2.39±0.25) levels in the RA group were significantly higher than those in the healthy control group at the baseline (0.84±0.16, 1.4±0.5, 304±101, 0.58±0.11, 1.09±0.27; t=15.36, 18.60, 18.77, 19.67, 21.66; P<0.05). MiR-21-5p (0.91±0.09) was lower than the control group (1.51±0.21; t=-16.029, P<0.05), while miR-146a-3p, miR-21-3p, miR-223-5p showed no difference between the two groups. MiR-155 and miR-146a was positively correlated with RA disease activity scores (P<0.05). MiR-21 was negatively correlated with disease activity scores and serum cytokines including IL-1β, IL-6, IL-17a, IL-23 and Tumor necrosis factor (TNF)-α. After 3 months treatment, tenderness joint count, swelling joint count, laboratory tests and imaging examination were improved (P<0.05), while miRNAslevels in RA were decreased significantly respectively (P<0.05), mir-21 was increased significantly. Conclusion MiR-125b, miR-21, miR-155, miR-346, miR-223, miR-146a in RA are characteristically expressed in RA and related with the disease activity and treatment response. MiRNAs may hold a great promise as the diagnostic and prognostic biomarkers in RA.
  • 摘要：提高对CTD患者免疫抑制治疗中出现进行性多灶性白质脑病的认识.本文对1例SLE,长期免疫抑制治疗中新发视物模糊,误诊为神经精神狼疮的病例进行总结.患者49岁女性,诊断SLE 14年,长期接受糖皮质激素、免疫抑制剂治疗.患者半年来出现进行性加重的双侧视物模糊,视野检查提示象限盲,头核磁共振发现以双侧顶枕叶为主的异常信号,腰椎穿刺常规病原学检查阴性.按照神经精神狼疮给予冲击量糖皮质激素后病情仍持续恶化,复查影像学原颅内异常信号范围增大,脑脊液高通量测序检出John Cunningham病毒.根据临床、影像学特点结合脑脊液发现,临床诊断进行性多灶性白质脑病,逐渐下调免疫抑制治疗强度后患者临床症状趋于稳定.本研究认为,长期接受免疫抑制治疗的CTD患者,出现新发中枢神经系统病变且不易用原发病解释时,应注意进行性多灶性白质脑病可能.

    中华风湿病学杂志的期刊信息

    • 曾用名：风湿病学杂志
    • 创刊时间：1997
    • 地区：CN
    • 语言：中文
    • 热门主题：中华医学会
    • 学科分类： 内科学;

    中华风湿病学杂志的获奖情况

    中华风湿病学杂志的收录情况

    • • 北大核心期刊（2008版）
    • • 北大核心期刊（2011版）
    • • 北大核心期刊（2014版）
    • • 北大核心期刊（2017版）
    • • 化学文摘（网络版）
    • • 中国科学引文数据库（2011-2012）
    • • 中国科学引文数据库（2013-2014）
    • • 中国科学引文数据库（2015-2016）
    • • 中国科学引文数据库（2017-2018）
    • • 中国科学引文数据库（2019-2020）
    • • 日本科学技术振兴机构数据库
    • • 中国科技核心期刊

    中华风湿病学杂志的投稿信息

    • 投稿方式：在线投稿
    • 投稿须知：点击查看
    • 期刊官方网站：点击前往
    • 版面费：平均 400 元/页
    • 审稿费：平均 50 元/篇元
    • 通讯地址：山西省太原市东华门23号
    • 邮编：030001
    • 联系电话：0351-7553295 7553182
    • 邮箱：cmafsb@163.com
    • 期刊栏目：论著；临床研究；基础研究；短篇论著；病例报告；综述；作者·编者·读者；消息
    免费订阅本刊

    客服邮箱：kefu@zhangqiaokeyan.com

    京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有 出版物经营许可证

    • 客服微信

    • 服务号