类风湿关节炎患者外周血CD34^＋造血干／祖细胞的检测及其意义  

The clinical significance of peripheral blood hematopoietic stem/progenitor cell in patients with rheumatoid arthritis

作　　者：陈杰 钱龙 秦明明 汪国生 李向培 

机构地区：[1]安徽医科大学附属省立医院风湿免疫科,合肥230023

出　　处：《中华风湿病学杂志》2010年第12期808-810,共3页Chinese Journal of Rheumatology

基　　金：国家自然科学基金（30840072）;中华医学会临床医学科研专项资金（08010100088）

摘　　要：目的探讨类风湿关节炎（RA）外周血造血干，祖细胞（HSC／HPC）的数量及细胞膜CD34平均荧光强度（MFI）变化及其与临床指标的关系，以期阐明其在RA中的意义。方法收集34例RA患者和16名健康对照者外周血，利用单克隆抗体标记CD34＋细胞，流式方法测定CD34＋HSC／HPC所占外周血淋巴细胞的比例及膜CD34的MFI，分析其与外周血细胞计数、疾病活动病程和药物应片j的关系。数据分析采用￡检验和厅差分析，相关性分析采用Pearson相关分析。结果①RA患者CD34＋细胞在外周血中淋巴细胞中所占的比例比健康人偏低[分别为（0．13±0．09）％和（0．38±0．21）％，P〈0．05]，但两者所占外周血淋巴细胞的比例均低于0．5％；但MFI偏高（分别为57±33和31±11，P〈0．05）。②RA患者CD34＋细I胞侄外周血淋巴细胞中所占的比例与外周血红绌胞训数、血红蛋白浓度呈正相关性，和C反应蛋白呈负相关；其MFI与健康评价问卷表（HAQ）评分、X线分期呈正相关，与血小板计数呈负相关。③RA患者CD34＋细胞在外周血淋巴细胞中所占比例的降低程度以及MFI与疾病的活动性、病程和用药情况无明显相关性（P〉0．05）。结论造血干细胞可能在RA的发病机制中起作用。Objective To measure the number of peripheral blood CD34＋ hematopoietic stern/progenitor cells （HSC/HPC） expression of CD34 in the peripheral blood of patients with rheumatoid arthritis and exploreits relationship with clinical manifestations. Methods CD34＋HSC/HPCs in the peripheral blood of RA patients （n=32） and heahhy controls （n=16） were detected using flow eytometry. The relationship between the frequency of HSC/HPCs, mean fluorescence intensities （MFI） of CD34 and clinical manifestations and rheumatoid factor （RF）, anti-cyclic citmllinated peptide （CCP） antibodies, disease activity score （DAS） 28, X rays stages and healthy assessment questionnaire （HAQ） were analyzed. Student＇s t-test and pearont test were used for statistical analysis. Results Frequency of CD34＋ HSC/HPC in the peripheral blood of RA patients was decreased compared with normal controls [ （0.13±0.09）% vs （0.38±0.21）%, P〈0.05] , CD34 MFI were higher in RA patients than those in the norInal controls （57±33 vs 31±11, P〈0.05）. The frequency was positively correlated with the number of （RBC red blood cell）, （Hb hemoglobin）, and was negatively correlated with C-reactive protein （CRP）, and the MFI of RA patients was positively con＇elated ,with healthy assessment questionnaire （HAQ） and X ray stages, hut negatively correlated with the number of platelets. Conclusion CD34＋ HSC/HPC of the peripheral blood of RA patients are significantly abnormal, which is characterized by decreased CD34＋ hematopoietic stem cell, and the decrease is positively ton＇elated with RBC and Hb, but negatively correlated with CRP. CD34＋ hematopnietie stem cell may play an important role in the pathogenesis of RA.

关 键 词：关节炎 类风湿 抗原 CD34 造血千细胞 

分 类 号：R686[医药卫生—骨科学]