强直性脊柱炎患者外周血CD4^(+)CD25^(+)Foxp3^(+)调节性T细胞的变化及临床意义  

Changes and clinical significance of CD4^(+)CD25^(+)Foxp3^(+)regulatory T cells in peripheral blood of patients with ankylosing spondylitis

作　　者：陈溶微[1] 谢文静[1] 江裕[1] 马国斌[2] CHEN Rongwei;XIE Wenjing;JIANG Yu;MA Guobin(Department of Laboratory Medicine,The Second Hospital of Fuzhou City,Fuzhou 350007,Fujian,China;Department of Cardiology,The Second Hospital of Fuzhou City,Fuzhou 350007,Fujian,China)

机构地区：[1]福建省福州市第二医院检验科,福建福州350007 [2]福建省福州市第二医院心内科,福建福州350007

出　　处：《右江医学》2022年第4期280-285,共6页Chinese Youjiang Medical Journal

基　　金：福建省自然科学基金(2020J011195)。

摘　　要：目的探讨强直性脊柱炎(ankylosing spondylitis,AS)患者外周血CD4^(+)CD25^(+)Foxp3^(+)调节性T细胞(Treg)的变化及临床意义,为其临床诊治提供参考。方法选择福州市第二医院风湿免疫科及骨科在2018年10月至2021年3月收治的80例AS患者作为研究对象,根据Bath AS疾病活动指数评分(BASDAI)不同将患者分为非活动组(n=50,BASDAI<4)和活动组(n=30,BASDAI≥4)两组,另取同期体检的50名健康者作为对照组。比较各组受试者相关血清学指标变化,观察各组外周血CD4^(+)CD25^(+)Foxp3^(+)Treg、CD8^(+)CD28^(+)Tc、CD8^(+)CD28^(-)Treg及CD8^(+)CD28^(+)/CD8^(+)CD28^(-)值差异,采用Pearson法对CD4^(+)CD25^(+)Foxp3^(+)Treg、CD8^(+)CD28^(+)Tc、CD8^(+)CD28^(-)Treg及CD8^(+)CD28^(+)/CD8^(+)CD28^(-)与BASDAI、血沉(ESR)、超敏C反应蛋白(hs-CRP)的相关性进行分析。结果活动组的BASDAI分级评分高于非活动组,活动组和非活动组的血清hs-CRP、ESR水平均明显高于对照组,且活动组高于非活动组,差异有统计学意义(P<0.05)。活动组和非活动组的外周血CD8^(+)CD28^(+)/CD8^(+)CD28^(-)、CD8^(+)CD28^(+)Tc细胞值及血清IL-17A、IFN-γ、TNF-α、IL-6水平均明显高于对照组,外周血CD8^(+)CD28^(-)Treg、CD4^(+)CD25^(+)Foxp3^(+)Treg均明显低于对照组,且活动组上述指标变化更为显著(P<0.05)。经Pearson相关性分析显示,CD4^(+)CD25^(+)Foxp3^(+)Treg与BASDAI分级、ESR及hs-CRP均呈负相关(P<0.001),CD8^(+)CD28^(+)Tc及CD8^(+)CD28^(+)/CD8^(+)CD28^(-)值与BASDAI分级均呈正相关(P<0.05)。结论外周血CD4^(+)CD25^(+)Foxp3^(+)调节性T细胞表达异常,在疾病发生发展过程中作用显著,且与AS疾病BASDAI评分呈负相关,具有一定的临床参考价值。Objective To investigate the changes and clinical significance of CD4^(+)CD25^(+)Foxp3^(+)regulatory T cells(Treg)in peripheral blood of patients with ankylosing spondylitis(AS),so as to provide references for clinical diagnosis and treatment.Methods 80 AS patients admitted to the Department of Rheumatology and Immunology and Orthopedics of The Second Hospital of Fuzhou City from October 2018 to March 2021 were selected as research objects.According to the Bath AS disease activity index score(BASDAI),patients were divided into inactive group(n=50,BASDAI<4)and active group(n=30,BASDAI≥4).In addition,50 healthy people who received physical examination during the same period were selected as control group.The changes of relevant serum indexes of subjects in each group were compared,and the differences of CD4^(+)CD25^(+)Foxp3^(+)Treg,CD8^(+)CD28^(+)Tc,CD8^(+)CD28^(-)Treg and CD8^(+)CD28^(+)/CD8^(+)CD28^(-)values in peripheral blood of each group were observed.In addition,Pearson method was used to analyze the correlation between CD4^(+)CD25^(+)Foxp3^(+)Treg,CD8^(+)CD28^(+)Tc,CD8^(+)CD28^(-)Treg,CD8^(+)CD28^(+)/CD8^(+)CD28^(-)and BASDAI,erythrocyte sedimentation rate(ESR),and hypersensitive C-reactive protein(hs-CRP).Results The BASDAI grading score of the active group was significantly higher than that of the inactive group,the levels of serum hs-CRP and ESR in the active group and the inactive group were significantly higher than those in the control group,and those of the active group were higher than those in the inactive group,and difference was statistically significant(P<0.05).The CD8^(+)CD28^(+)/CD8^(+)CD28^(-)and CD8^(+)CD28^(+)Tc cell values in peripheral blood and serum IL-17A,IFN-γ,TNF-α,IL-6 levels of the active group and the inactive group were significantly higher than those of the control group,while the CD8^(+)CD28^(-)Treg and CD4^(+)CD25^(+)Foxp3^(+)Treg in peripheral blood were significantly lower than those in the control group,and the changes in the above indicators in the active group were mo

关 键 词：强直性脊柱炎 活动度 CD4^(+)CD25^(+)Foxp3^(+) 调节性T细胞 

分 类 号：R593.23[医药卫生—内科学]