腰椎间盘退变性疾病与外周血淋巴细胞亚群的关系  

Relationship between degenerative lumbar disc disease and peripheral blood lymphocyte subsets

作　　者：冯阳 严旭[1] 王永魁 杨腾越 尚利杰 张春霖[1] Feng Yang;Yan Xu;Wang Yongkui;Yang Tengyue;Shang Lijie;Zhang Chunlin(Department of Orthopedics,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州大学第一附属医院骨科

出　　处：《中国组织工程研究》2020年第17期2630-2635,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81802128)，项目负责人：王永魁~~

摘　　要：背景:既往研究认为椎间盘退变的主要原因为遗传、衰老、营养不良和负荷史,免疫系统在椎间盘退变过程中的作用尚不清楚。目的:观察腰椎间盘退变患者外周血淋巴细胞亚群的变化,并研究腰椎间盘退变程度与外周血各淋巴细胞亚群的关系。方法:收集76例腰椎间盘退变性疾病患者和56例健康志愿者(对照组)的血样,用流式细胞仪检测外周血各淋巴细胞亚群,包括CD3+T细胞、CD4+T细胞、CD8+T细胞、CD19+B细胞、CD3-CD16+CD56+自然杀伤细胞等淋巴细胞亚群的百分率,计算CD4+/CD8+比值。采用Pfirrmann分级标准评估2组腰椎间盘退变程度和分级,进一步评估外周血各淋巴细胞亚群与腰椎间盘退变程度的相关性。研究经郑州大学第一附属医院伦理审查委员会批准(伦理批号:2019-KY-285),所有受试者都签署了知情同意书。结果与结论:①腰椎间盘退变性疾病组的腰椎间盘退变程度明显高于对照组(P<0.05);②腰椎间盘退变性疾病组CD4+T细胞百分率、自然杀伤细胞百分率和CD4+/CD8+比值明显高于对照组(P<0.05);腰椎间盘退变性疾病组CD8+T细胞百分率较对照组显著降低(P<0.05);③对照组腰椎间盘退变程度与外周血各淋巴细胞亚群无相关性;腰椎间盘退变性疾病组腰椎间盘退变程度与CD4+T细胞百分率、CD4+/CD8+比值、自然杀伤细胞百分率成线性正相关(r=0.412,P=0.000;r=0.715,P=0.000;r=0.494,P=0.000),与CD8+T细胞百分率成线性负相关(r=-0.737,P=0.000);④结果表明,腰椎间盘发生退行性改变可能与外周血各淋巴细胞亚群改变有关,且CD4+T细胞增多、自然杀伤细胞增多以及CD4+/CD8+比值增高可能加速腰椎间盘退变。提示,免疫系统改变预示腰椎间盘退变发生的可能,其有望成为腰椎间盘退变性疾病的防治靶点。BACKGROUND:Previous studies have suggested that the main causes of disc degeneration are heredity,aging,malnutrition and load history.The role of immune system in the process of intervertebral disc degeneration is not clear.OBJECTIVE:To observe the changes of peripheral blood lymphocyte subsets in patients with lumbar disc degeneration,and to study the relationship between the severity of lumbar disc degeneration and peripheral blood lymphocyte subsets.METHODS:Blood samples were collected from 76 patients with degenerative lumbar disc disease(experimental group)and 56 healthy volunteers(control group).The percentages of peripheral blood lymphocyte subsets including CD3+T cells,CD4+T cells,CD8+T cells,CD19+B cells,and CD3-CD16+CD56+natural killer(NK)cells were measured by flow cytometry.The ratio of CD4+/CD8+was calculated.The Pfirrmann grading standard was used to evaluate the grade of lumbar disc degeneration in the two groups,and the correlation between peripheral blood lymphocyte subsets and lumbar disc degeneration was further evaluated.The study protocol was approved by the Ethic Committee of the First Affiliated Hospital of Zhengzhou University in China with approval No.2019-KY-285.Each participant signed informed consent prior to the study.RESULTS AND CONCLUSION:The degenerative grade of the experimental group was significantly higher than that in the control group(P<0.05).The percentages of CD4+T cells,NK cells and the ratio of CD4+/CD8+in the experimental group were significantly higher than those in the control group(P<0.05).The percentage of CD8+T cells in the experimental group was significantly lower than that in the control group(P<0.05).There was no correlation between the grade of lumbar disc degeneration and lymphocyte subsets of the peripheral blood in the control group.In the experimental group,there was a linear positive correlation between the grade of lumbar disc degeneration and the percentage of CD4+T cells,the ratio of CD4+/CD8+,and the percentage of NK cells(r=0.412,P=0.000;r=0.715,P=0.0

关 键 词：腰椎间盘退变 淋巴细胞亚群 自身免疫 T淋巴细胞 B淋巴细胞 NK细胞 

分 类 号：R446[医药卫生—诊断学] R496[医药卫生—临床医学]