膝骨关节炎特异性自身抗体的表达对淋巴细胞凋亡的影响  

Effect of Expression of Specific Autoantibodies on Lymphocyte Apoptosis in Knee Osteoarthritis

作　　者：张强 张敏 黄志荣 王高 胡中立 章智华 ZHANG Qiang;ZHANG Min;HUANG Zhirong;WANG Gao;HU Zhongli;ZHANG Zhihua(Hongdu Hospital of Traditional Chinese Medicine Affiliated to Jiangxi University of Traditional Chinese Medicine,Nanchang Jiangxi 330006,China)

机构地区：[1]江西中医药大学附属洪都中医院,江西南昌330006

出　　处：《药品评价》2021年第18期1128-1132,共5页Drug Evaluation

基　　金：江西省卫生计生委科技计划项目(20167075)。

摘　　要：目的:研究膝骨关节炎(KOA)特异性自身抗体的表达对B、T淋巴细胞凋亡的影响以及临床意义。方法:以江西中医药大学附属洪都中医院82例KOA患者为研究组,同期体检健康者82例作为对照组,按照KOA严重程度评级标准将研究患者又分为KOA轻、中、重度三个亚组。间接免疫荧光法(IIF)联合ELISA法测角蛋白(AKA)、核周因子(APF)、瓜氨酸(anti-CCP)抗体在各组的表达;流式细胞仪测各组淋巴细胞凋亡率;ROC曲线分析各抗体对KOA的诊断价值;logistic回归分析影响KOA病情的危险因素;最后对KOA患者血清特异性自身抗体与T、B淋巴细胞凋亡率作相关性分析。结果:研究组中三者的表达较对照组差异有统计学意义(P<0.05);特异性自身抗体的相对表达随着KOA患者病情严重程度的加重呈梯度依赖性上升(P<0.05);KOA重度组患者的T、B淋巴细胞凋亡率较对照组极显著降低(P<0.05);特异性自身抗体AKA、APF、anti-CCP对KOA均具有良好的诊断价值(敏感度分别为81.559%,88.784%,61.003%;特异度分别为90.110%,91.887%,90.856%);三种自身抗体均是影响KOA患者病情程度的独立危险因素(P<0.05);AKA与B、T淋巴细胞负相关(R=-0.633,-0.498,P<0.05);APF与B、T淋巴细胞负相关(R=-0.478,-0.654,P<0.05);anti-CCP与B、T淋巴细胞负相关(R=-0.553,-0.378,P<0.05)。结论:KOA患者血清特异性自身抗体的表达越高,淋巴细胞的凋亡率就越低,且其对于KOA的疾病诊断及病情提示都有一定的临床价值。Objective:To investigate the effect of specific autoantibodies on apoptosis of B and T lymphocytes in patients with knee osteoarthritis(KOA)and its clinical significance.Methods:82 patients with KOA in Hongdu Hospital of Traditional Chinese Medicine,Jiangxi University of Traditional Chinese Medicine were selected as the study group,and 82 healthy subjects were selected as the control group.The study patients were further divided into three groups according to the KOA severity rating criteria:mild,moderate,and severe KOA.Indirect immunofluorescence(IIF)combined with ELISA was used to detect the expression of keratin(AKA),perinuclear factor(APF)and citrulline(anti-CCP)antibodies in each group;flow cytometry was used to measure the lymphocyte apoptosis rate in each group;ROC curve was used to analyze the diagnostic value of each antibody for KOA;logistic regression was used to analyze the risk factors affecting the condition of KOA;finally,the correlation analysis was performed between serum specific autoantibodies and the apoptosis rate of T and B lymphocytes in KOA patients.Results:There was significant difference in the expression of the three in the study group compared with the control group(P<0.05);the relative expression of specific autoantibodies increased in a gradient-dependent manner with the severity of KOA patients(P<0.05);the apoptosis rate of T and B lymphocytes in the severe KOA group was significantly lower than that in the control group(P<0.05);specific autoantibodies AKA,APF,and anti-CCP had good diagnostic value for KOA(sensitivity 81.559%,88.784%,and 61.003%,respectively;specificity 90.110%,91.887%,and 90.856%,respectively);all three autoantibodies were independent risk factors affecting the severity of KOA patients(P<0.05);AKA was negatively correlated with B and T lymphocytes(R=-0.633,-0.498,P<0.05);APF was negatively correlated with B and T lymphocytes(R=-0.478,-0.654,P<0.05);anti-CCP was negatively correlated with B and T lymphocytes(R=-0.553,-0.378,P<0.05).Conclusion:The lower the apoptosis

关 键 词：膝骨关节炎 特异性自身抗体 细胞凋亡 

分 类 号：R684.3[医药卫生—骨科学]