类风湿关节炎患者Th细胞亚群的检测及其临床意义  

Th Subset in Rheumatoid Arthritis and Clinic Significance

作　　者：陈海燕[1] 韩捷[1] 华咏[2] 王维东[1] 沈培辰[1] 

机构地区：[1]上海市同济大学附属东方医院风湿免疫科,200120 [2]上海市同济大学附属东方医院中心实验室,200120

出　　处：《中国误诊学杂志》2008年第6期1272-1274,共3页Chinese Journal of Misdiagnostics

摘　　要：目的:探讨类风湿关节炎(RA)患者外周血和关节液中Th1、Th2型细胞在患者病情演变中的特点及临床意义。方法:用流式细胞术检测RA患者及健康人外周血单个核细胞(PBMC)和关节液单个核细胞(SFMC)中IFN-γ、IL-4阳性细胞比例。结果:RA患者外周血和关节液中以IFN-γ阳性细胞百分率和IFN-γ阳性细胞/IL-4阳性细胞比值明显增高;早期RA患者以IFN-γ阳性细胞百分率和IFN-γ阳性细胞/IL-4阳性细胞比值增高为主,非早期RA患者以IL-4阳性细胞百分率增高为甚。IFN-γ阳性细胞百分率与血沉、晨僵、休息痛、STOKE指数呈正相关关系。IL-4阳性细胞百分率与类风湿因子显著正相关。结论:RA患者外周血及关节液中存在Th细胞亚群比例失调。早期RA及关节液表现为Th1亚群细胞增多,而非早期RA以Th2亚群细胞增多。Th1、Th1/Th2与RA临床症状及活动指标密切相关,药物干预Th1/Th2失衡是RA治疗新的途径。Objective：To investigate the blood and synovial fluid levels of Th1,Th2 in patient with rheumatoid arthritis ,the changeable features in arthritis duration and the significance to clinic. Methods ：subcellular molecule IFN-γ and IL-4 were labeled in PBMC and SFMC from patients with rheumatoid arthritis and controls by immuno-fluorence staining method. Detection was performed by FACSCaliur. Result：The blood and synovial fluid number of IFN-γ^＋ cell and IFN-γ＋/IL-4^＋ ratio in patients with rheumatoid arthritis was significantly higher compared with normal controls. In early rheumatoid arthritis individuals ,the blood number of IFN-γ^＋ cell and IFNγ^＋/IL-4^＋ ratio was significantly higher compared with normal controls ,as for IL-4^＋ cells ,it had been found in a higher level in not early rheumatoid arthritis individuals than in controls. We had also found the correlation between IFN-γ^＋ cell and ESR,morning stiffness,rest pain, STOKE index,IL-4^＋ cells and RF. Conclusion ：The abnormal blood and synovial fluid levels of Th1/Th2 subset are observed in rheumatoid arthritis. The blood and synovial fluid of Th1 subtype is in predominance in early stage. As for IL- 4^＋ cells,it has been found in a higher level in not early rheumatoid arthritis patients. Th1 ,Th1/Th2 have an important correlation to rheumatoid symptom and activity index. Medicine intervention to Th1/Th2 imbalance is a new clinic therapeutical way in rheumatoid arthritis.

关 键 词：关节炎 类风湿/免疫学 Th1细胞/免疫学 Th2细胞/免疫学 人类 

分 类 号：R392.8[医药卫生—免疫学]