镓铝砷激光局部治疗对类风湿关节炎患者调节T细胞和局部炎性介质的影响  

Effect of Ga-Al-As laser irradiation on CD4^＋ CD25^＋ regulatory T cells and local inflammatory media in rheumatoid arthritis

作　　者：潘文萍[1] 马丽莉[4] 庄桂英[2] 刘文波[1] 曹莉莉[3] 

机构地区：[1]山东大学附属千佛山医院风湿免疫科,济南250014 [2]山东大学附属千佛山医院康复理疗科,济南250014 [3]山东大学附属千佛山医院中心试验室,济南250014 [4]山东省警官总医院

出　　处：《中华物理医学与康复杂志》2011年第2期141-144,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的探讨镓铝砷激光联合药物治疗类风湿关节炎（RA）的机制。方法将22例RA患者分为观察组和对照组，每组11例。观察组采用镓铝砷激光＋甲氨蝶呤治疗，对照组仅采用甲氨蝶呤治疗。采用流式细胞双抗染色法分别测定患者治疗前、后外周血和膝关节滑液中CD4^＋CD25^＋ treg（调节性T细胞）的数量，采用酶联免疫吸附法测定治疗前、后患者膝关节滑液中前列腺素E2（PGE2）的含量。同时检测10名健康人（正常对照组）外周血CD4^＋CD25^＋treg细胞数量。结果观察组膝关节局部症状改善优于对照组；2组治疗后膝关节滑液中PGE2含量分别为（3．82±1．34）和（1．69±0．98），均较治疗前下降，其中观察组下降幅度明显高于对照组，差异具有统计学意义（P〈0．05）；患者外周血CD4^＋CD25^＋ treg细胞数量为（3．84±3．20）％，明显低于正常对照组，差异存在统计学意义（P〈0．05）。滑液中CD。’CD，，’treg远多于外周血。观察组治疗后关节滑液中CD。’CD：，’treg的数量为（9．78±10．28）％，与治疗前比较差异存在统计学意义（P〈0．05）。结论镓铝砷激光联合甲氨蝶呤治疗类风湿关节炎临床疗效优于单纯应用甲氨蝶呤，联合治疗的机制可能在于明显减少靶器官局部炎性介质和CD4^＋CD25^＋ treg细胞数量。Objective To explore the mechanism of combined treatment with methotrexate （MTX） and Ga- Al-As laser irradiation for rheumatoid arthritis （RA） and to assess the effectiveness of Ga-Al-As laser therapy for RA. Methods Twenty-two patients with RA were randomly and evenly divided into two groups： the treatment group treated with Ga-Al-As laser irradiation combined with MTX and the control group treated with MTX only. Ten age-matched normal subjects were observed as normal controls. The amount of CD4^＋ CD25^＋ regulatory T cells in peripheral blood （PB） of the normal controls and that in the PB and synovial fluid （SF） of the 22 patients before and after therapy were counted by flow eytometry. Meanwhile, the amount of prostaglandin E2 （PGE2） in synovial fluid of the patients was measured before and after treatment by enzyme-linked immunosorbent assay（ ELISA）. Results After combined treatment the clinical symptoms of the patients were improved significantly, and the amount of PGE2 in SF decreased significantly. The count of CD4^＋ CD25^＋ regulatory T cells in PB of RA patients was （3. 84 ＋ 3.20） % , compared to （10.05 ＋ 7.04）% in healthy individuals. The count of CD4^＋ CD25^＋ regulatory T cells in SF of RA patients was （ 14.89 ＋ 12.30） % , much higher than that in PB. The count of CD4^＋ CD25^＋ regulatory T cells in SF decreased significantly in treatment group compared to control group （ P 〈 0.05）. Conclusion Ga-Al-As laser irradiation combined with MTX can effectively improve the clinical symptoms of RA patients. It may be related to the decrease of amount of PGE2 and count of CD4^＋ CD25^＋ regulatory T cell in PB and SF.

关 键 词：类风湿关节炎 CD4^+CD25^+调节性T细胞 前列腺素E2 镓铝砷激光 

分 类 号：R593.22[医药卫生—内科学]