类风湿关节炎滑膜细胞的免疫探讨  

THE ABNORMALITIES OF THE CELLULAR IMMUNITY IN RHEUATOID SYNOVIUM

作　　者：薛成森 董怡[1] 于孟学[1] 何祖根[1] 王德田[1] 吕厚山[1] 高彤[1] 董天祥[1] 

机构地区：[1]北京协和医院内科,北京协和医院病理科,北京医科大学人民医院,北京市建筑工人医院

出　　处：《中华内科杂志》1994年第9期601-604,共4页Chinese Journal of Internal Medicine

摘　　要：用免疫组织化学方法观察了１８例类风湿关节炎（ＲＡ）患者滑膜中淋巴细胞亚群。ith the technique of immunohistochemical(ABC) method monoclonal antibodies were used to identify the lymphocyte subsets,macrophage and the expression of class lI MHC(NLA-DR,HLA-DQ)antigens in the synovium cells from 18 RA patients and 8 patients with osteoarthritis as con-trol. The results showed that the main cellular abnormality at the sublayer of the synovium was the ap- pearance of lymphoid follicles which mainly consisted of the infiltration of T lymphocytes(77.8%).50.6% of them were CD￣ +_4,which mainly consisted by of CD_(45)RO￣+ells in the rheumatoid synovium on the consecutive sections.The increased ratio of CD_4 / CD_8 in RA patients was signifiantly higher when compared with that in the controls(2.11±0.93 vs 0.63 ± 0.13,P<0.00 1).In advanced RA with fibrosis of joints,the ratio tended to decrease and was accompanied with reduction of infiltrated lymphocytes.Compared with T cells CD￣+_20Blymphocyte not only had a lower percentage(25.2%),but also showed a characteristic picture of locating in the centre of the follicles. The fact that most of the CD￣+_4Tcells was helper memorizcd lymphocytes with CD_4 phenotype of positive TAC(+) (interlukin-2 receptor) and that up to 54.2% was anti-HLA-DR and 54.1%anti-HLA-DQmonoclonal antibodies indicated that these T lymphocytes were activated in vivo. Cells with anti-CD￣+_68were seen all over the RA synovium. Class lI HLA and CD_(68)molecule were also expressed on the endothelium cells of the small vessels. It is suggested that the activated lymphocytes,macrophages and endothelium cells and their abnormal distribution may indicate the abnormalities of the cellular immunity in rheumatoid synovium.

关 键 词：关节炎 类风湿性 细胞免疫 

分 类 号：R593.220.3[医药卫生—内科学]