T细胞亚群在新疆地区急慢性布鲁菌病中表达的差异及与患者骨关节症状的关系  

Study on the difference of T cell subgroup in acute and chronic brucellosis in Xinjiang and its relationship with patients bone and joint symptoms

作　　者：张韬[1] 张丽娟[1] 韩丹[1] ZHANG Tao;ZHANG Li-juan;HAN Dan(Department 2,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China)

机构地区：[1]新疆医科大学第一附属医院感染二科,新疆乌鲁木齐830054

出　　处：《热带医学杂志》2021年第1期70-74,共5页Journal of Tropical Medicine

基　　金：新疆重大疾病医学重点实验室资助项目(SKLIB-XJMDR-2014-2)。

摘　　要：目的探讨T细胞亚群在新疆地区急慢性布鲁菌病中表达的差异及与患者骨关节症状的关系。方法选取2017年1月-2019年12月新疆医科大学第一附属医院收治的102例布鲁菌病患者,其中43例为急性期布鲁菌病患者(急性组)、59例为慢性期布鲁菌病患者(慢性组),并选取体检中心60名健康人群作为对照组。比较各组、有无骨关节受累患者外周血T细胞亚群水平,采用Pearson分析T细胞亚群与骨代谢指标[骨保护素(OPG)、抗酒石酸酸性磷酸酶5b(TRACP5b)、基质金属蛋白酶-2(MMP-2)]的相关性,采用Logistic多元回归方程行多元线性回归分析,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析T细胞亚群预测骨关节受累的效能。结果急性组CD3^(+)T细胞、CD4^(+)T细胞、CD4^(+)/CD8^(+)高于慢性组、对照组,差异有统计学意义(P<0.05);慢性组CD3^(+)、CD4^(+)T细胞高于对照组,CD4^(+)/CD8^(+)低于对照组,差异有统计学意义(P<0.05)。有骨关节受累患者CD3^(+)T细胞、CD4^(+)T细胞、TRACP5b、MMP-2高于无关节受累患者,OPG低于无关节受累患者,差异有统计学意义(P<0.05)。CD3^(+)、CD4^(+)T细胞与OPG呈负相关,与TRACP5b、MMP-2呈正相关(P<0.05);多元线性回归分析显示,控制了年龄、性别等因素外,CD3^(+)T细胞、CD4^(+)T细胞、OPG、TRACP5b、MMP-2仍是骨关节受累的相关影响因素(P<0.05)。结论新疆地区布鲁菌病急性期患者T细胞亚群免疫调节以CD3^(+)、CD4^(+)T细胞为主,慢性期以CD8^(+)T细胞为主,CD3^(+)、CD4^(+)T细胞可能通过调节骨代谢参与布鲁菌病骨关节受累的发生。Objective To explore the difference in T cell subsets in acute and chronic brucellosis in Xinjiang and its relationship with patients’bone and joint symptoms.Methods 102 patients with brucellosis admitted in the First Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2019 were selected,including 43 patients withacute brucellosis(acute group)and 59 patients with chronic brucellosis(chronic group),and 60 people from the physicalexamination center were selected as the control group.The levels of T-cell subsets in peripheral blood of patients with orwithout bone and joint involvement were compared in each group.Pearson was used to analyze the correlation between T cellsubsets and bone metabolism indexes[osteoprotegerin(OPG),tartrate resistant acid phosphatase 5 b(TRACP5 b),matrixmetalloproteinase-2(MMP-2)];logistic multiple regression equation was used to perform multiple linear regressionanalysis,and receiver operating characteristic curve(ROC)and area under ROC(AUC)were used to analyze the efficacyof T cell subsets in predicting bone and joint involvement.Results CD3^(+)T cells,CD4^(+)T cells,CD4^(+)/CD8^(+)in acute groupwere higher than those in chronic group and control group;CD3^(+)T cells,CD4^(+)T cells in chronic group were higher thanthose in control group;CD4^(+)/CD8^(+)T cells were lower than that in control group,the difference was statistically significant(P<0.05).The CD3^(+)T cells,CD4^(+)T cells,TRACP5 b and MMP-2 of patients with bone and joint involvement were higherthan those without joint involvement,and OPG was lower than those without joint involvement,the difference wasstatistically significant(P<0.05).CD3^(+)and CD4^(+)T cells were negatively correlated with OPG,and positively correlated withTRACP5 b and MMP-2,the difference was statistically significant(P<0.05).Multiple linear regression analysis showed that,in addition to controlling age and gender,CD3^(+)T cells,CD4^(+)T cells,OPG,TRACP5 b,and MMP-2 were relatedinfluencing factors of bone and joint involvement

关 键 词：T细胞亚群 急性布鲁菌病 慢性布鲁菌病 骨关节症状 骨代谢指标 

分 类 号：R516.7[医药卫生—内科学]