类风湿关节炎患者B细胞功能变化及其相关性分析  

Changes of B Cell Function in Patients with Rheumatoid Arthritis and Correlation Analysis

作　　者：潘惠 汪元[2] PAN Hui;WANG Yuan

机构地区：[1]马鞍山市中医院,安徽马鞍山243000 [2]安徽中医药大学第一附属医院,安徽合肥230001

出　　处：《风湿病与关节炎》2018年第7期17-20,32,共5页Rheumatism and Arthritis

基　　金：国家自然科学基金青年基金项目(81302967);国家中医药重点学科中医痹病学建设项目(国中医药发[2009]30号);国家临床重点专科中医风湿病科建设项目(财社字[2013]239号);国家科技支撑计划课题(2012BA126B02);安徽省重点实验室建设项目(1306c083035);安徽省科技攻关项目(1301042211)

摘　　要：目的:探讨类风湿关节炎患者外周血中B细胞功能的变化及其与实验室指标、中医证候的关系。方法:选取60例类风湿关节炎患者,根据DAS28评分,分为高活动组24例,中低活动组36例;同时选取20例健康体检者为正常对照组。采用流式细胞仪检测B细胞计数、B细胞百分比;采用ELISA法检测抗环瓜氨酸肽(CCP)抗体、B细胞活化因子(BAFF)及其受体(BAFF-R);采用免疫透射比浊法检测免疫球蛋白Ig A、Ig G、Ig M,补体C3、C4及类风湿因子(RF)、C-反应蛋白(CRP);采用全自动血沉分析仪检测红细胞沉降率(ESR)。结果:类风湿关节炎患者的B细胞计数、B细胞百分比、BAFF、BAFF-R较正常对照组明显增高(P<0.05),且高活动组较中低活动组明显增高(P<0.01)。B细胞计数与RF、抗CCP抗体、ESR、CRP、C3、Ig G呈正相关(P<0.05);B细胞百分比与抗CCP抗体、ESR、CRP、C4呈正相关(P<0.05);BAFF与抗CCP抗体、ESR、CRP、C3、Ig G呈正相关(P<0.05);BAFF-R与CRP呈正相关(P<0.05)。B细胞计数与关节肿胀、关节压痛、关节局部发热、疲倦乏力、舌质紫暗呈正相关(P<0.05),B细胞百分比与关节肿胀、关节压痛、关节局部发热、纳食减少呈正相关(P<0.05),BAFF与关节肿胀、关节压痛、关节局部发热呈正相关(P<0.05),BAFF-R与纳食减少、大便稀溏呈正相关(P<0.05)。结论:类风湿关节炎患者的B细胞功能较正常人明显升高,与疾病活动度、中医证候呈正相关,说明B细胞功能变化可作为反映类风湿关节炎病情活动度的指标之一。Objective:To investigate the changes of B cell function in peripheral blood of patients with rheumatoid arthritis and their relationship with laboratory indexes and TCM syndromes.Methods:Sixty cases of rheumatoid arthritis were selected and divided into a high activity group(24 cases),a middle and a low activity group(36 cases)according to DAS28 score,and 20 healthy subjects were selected as a normal control group.The B cell count and the percentage of B cells were detected by flow cytometry.The anti CCP antibody,BAFF and its receptor BAFF-R were detected by ELISA,and immunoturbidimetry was used to detect immunoglobulin IgA,IgG,IgM,complement C3,C4 and rheumatoid factor(RF)and C-reactive protein(CRP).Erythrocyte sedimentation rate(ESR)was detected by automatic ESR analyzer.Results:The number of B cells,the percentage of B cells,BAFF and BAFF-R in the patients with rheumatoid arthritis were significantly higher than those in the normal control group(P<0.05),and those in the high activity group were significantly higher than the low activity group(P<0.01).The number of B cells was positively correlated with RF,anti CCP antibody,ESR,CRP,C3 and IgG(P<0.05),and the percentage of B cells was positively correlated with anti CCP antibody,ESR,CRP and C4(P<0.05).BAFF was positively correlated with anti CCP antibody,ESR,CRP,C3 and IgG(P<0.05).BAFF-R was positively correlated with CRP(P<0.05).There was a positive correlation between B cell count and joint swelling,joint tenderness,joint local fever,fatigue and lingual purple(P<0.05).The percentage of B cells was positively correlated with joint swelling,joint tenderness,joint local fever,and reduction of food intake(P<0.05).BAFF was positively correlated with joint swelling,joint tenderness,and joint local fever(P<0.05).BAFF-R was positively correlated with food intake reduction and loose stool(P<0.05).Conclusion:The B cell function of patients with rheumatoid arthritis is significantly higher than that of normal people,and it is positively related to the degree of disease a

关 键 词：关节炎 类风湿 B细胞功能 疾病活动度 中医证候 

分 类 号：R593.22[医药卫生—内科学]