类风湿关节炎寒热证候淋巴细胞亚群及细胞因子的差异分析  

Analysis of the Difference of Lymphocyte Subsets and Cytokines between Cold Syndrome and Heat Syndrome of Rheumatoid Arthritis

作　　者：姚传辉 陶庆文[2,3] 陈嘉琪 徐才钦 余新波 陈光耀 张丽宁 徐愿 YAO Chuan-hui;TAO Qing-wen;CHEN Jia-qi;XU Cai-qin;YU Xin-bo;CHEN Guang-yao;ZHANG Li-ning;XU Yuan(Graduate School,Beijing University of Traditional Chinese Medicine,Beijing,100029;Rheumatology Department of Traditional Chinese Medicine,China-Japan Friendship Hospital,Beijing,100029;Beijing Key Laboratory of Immune Inflammatory Diseases,Beijing,100029)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中日友好医院中医风湿病科,北京100029 [3]免疫炎性疾病北京市重点实验室,北京100029

出　　处：《中国中西医结合杂志》2021年第12期1456-1460,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金青年科学基金项目(No.81603588);国家临床重点专科能力建设项目(No.2001-ZDZK-001);北京市中医药科技发展资金项目(No.QN-2020-32);。

摘　　要：目的比较分析类风湿关节炎(RA)患者寒、热证候间外周血淋巴细胞亚群与相关细胞因子的差异。方法纳入RA患者115例,其中寒证58例,热证57例。采集中医证候数据,检测血沉(ESR)、C-反应蛋白(CRP)、免疫球蛋白及补体、类风湿因子(RF)、抗环瓜氨酸肽(CCP)抗体、外周血淋巴细胞亚群及相关细胞因子水平,分析淋巴细胞亚群数量及细胞因子在RA寒、热证候中的差异。结果与寒证组比较,热证组CD4^(+)T细胞、B2细胞、B1细胞、NK细胞数量降低,IL-1β、IL-8、IL-6、干扰素(IFN)-γ升高(P<0.05,P<0.01)。ROC曲线结果显示:CD4^(+)T/IL-6<30时,判断RA热证的敏感性为82.1%,特异性为82.4%;CD4^(+)T/IFN-α<205时,热证可能性大,其敏感性为60.7%,特异性为91.2%。结论寒、热证候间淋巴细胞数量及细胞因子有显著差异,CD4^(+)T/IL-6<30和CD4^(+)T/IFN-α<205是RA热证的特征性表现。Objective To compare the difference of peripheral blood lymphocyte subsets and related cytokines between rheumatoid arthritis(RA)patients with cold syndrome and heat syndrome.Methods Totally 115 RA patients were enrolled,including 58 with cold syndrome and 57 with heat syndrome.Chinese medicine(CM)syndrome data,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),immunoglobulin and complement,rheumatoid factor(RF),anti-cyclic citrullinated peptide(CCP)antibody,peripheral blood lymphocyte subsets and related cytokines were collected to analyze the difference of lymphocyte subsets and cytokine in RA cold/heat syndrome.Results The numbers of CD4^(+)T cells,B2 cells,B1 cells,NK cells in RA heat syndrome group were lower,and the levels of IL-1β,IL-8,IL-6 and interferon(IFN)-γin RA heat syndrome group were higher than those in RA cold syndrome group(P<0.05,P<0.01).ROC curve showed that when CD4^(+)T/IL-6<30,the sensitivity and specificity of judging RA heat syndrome were 82.1%and 82.4%respectively.When CD4^(+)T/IFN-αwas less than 205,the possibility of heat syndrome was high,with its sensitivity being 60.7%and specificity being 91.2%.Conclusions There were significant differences in lymphocyte number and cytokines between RA cold/heat syndromes.CD4^(+)T/IL-6<30 and CD4^(+)T/IFN-α<205 were the characteristic manifestations of RA heat syndrome.

关 键 词：类风湿关节炎 寒、热证候 细胞因子 淋巴细胞亚群 

分 类 号：R593.22[医药卫生—内科学]