血小板微粒及其表面标记物CD62P、CD154与类风湿关节炎的相关性研究  

Association of Elevated Platelet Microparticles with Disease Activity in Rheumatoid Arthritis

作　　者：薛丽佳[1] 崔贝贝[1] 李茜 黄巧容[3] 刘毅[1] 林辉[1] 

机构地区：[1]四川大学华西医院风湿免疫科,成都610041 [2]西南医科大学附属医院风湿科,泸州646000 [3]四川大学华西医院干细胞生物学研究室,成都610041

出　　处：《四川大学学报（医学版）》2017年第3期405-409,共5页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金(No.81102274);成都市科技攻关项目(No.10GGYB644SF-023)资助

摘　　要：目的观察血小板微粒(platelets microparticles,PMPs)在类风湿关节炎(RA)患者关节液和外周血中的表达及其与健康人外周血对照之间的差异,探讨PMPs水平与RA活动指标之间的关系。方法采用流式细胞术检测26例活动期[疾病活动指数(DAS)28≥3.2]RA患者外周血和15例健康对照组外周血PMPs含量、PMPs的CD62P、CD154阳性比率,检测RA患者和15例健康对照组外周血C反应蛋白(CRP)、血沉(ESR)、类风湿因子(RF)、抗环瓜氨酸肽抗体(ACPA)指标,分析PMPs含量与各指标相关性。其中16例有膝关节积液RA患者同时检测配对外周血和关节液PMPs含量及CD62P^+PMPs和CD154^+PMPs比率。结果 (1)RA患者外周血PMPs含量高于健康对照组(P<0.01),RA患者外周血PMPs含量高于配对关节液(P<0.01);(2)RA患者外周血CD62P^+PMPs比率高于健康对照组(P<0.05)和配对关节液(P<0.05);(3)RA患者外周血CD154^+PMPs比率高于健康对照组(P<0.01)和配对关节液(P<0.05);(4)RA患者外周血PMPs含量与疾病活动性评分DAS28(r=0.462,P=0.018)呈正相关,与ESR、CRP、RF、ACPA不存在相关性;而关节液PMPs含量与CRP、ESR、RF、ACPA、DAS28均无相关性。结论 RA患者外周血PMPs表达异常,且与疾病活动性有关,提示PMPs在RA疾病活动和关节损害中发挥重要作用。Objective To explore the expression of platelets microparticles （PMPs） in peripheral blood （PB） and synovial fluid （SF） of rheumatoid arthritis （RA） patients and its correlation with clinical inflammatory parameters. Methods The levels of PMPs in PB were detected by flow cytometry in 26 active RA patients and 15 healthy control （HC）. SF was collected from 16 patients. The percentages of CD62P＋ PMPs, CD154＂- PMPs and clinical parameters （including CRP, ESR, RF and ACPA） were also measured, then the correlations of PMPs with these parameters were analyzed. Results PMPs levels in PB of RA patients were higher than those in PB from HC and those in SF of RA patients （P〈 0.01）. CD62P＋ PMPs levels in PB of RA patients were higher than those in PB of HC and those in SF of RA patients （P〈 0.05）. CD154＋ PMPs levels in PB of RA patients were higher than those in PB of HC （P〈 0.01） and those in SF of RA patients （P〈 0.05）. The levels of PB PMPs were positively correlated with disease activity score DAS28 （r=0. 462, P=0. 018）, but not with ESR, CRP, RF or ACPA. The levels of SF PMPs were not correlated with any of them （P〈0.05）. Conclusion PMPs may be involved in immune regulation and systemic inflammation of RA. The elevated levels of PMPs could be a potential biomarker for RA.

关 键 词：类风湿关节炎 血小板微粒 流式细胞技术 关节液 

分 类 号：R593.22[医药卫生—内科学]