老年与非老年类风湿关节炎患者外周血中淋巴细胞亚群的差异性及其临床意义  

Difference and its clinical significance of peripheral blood lymphocyte subsets between elderly and non-elderly patients with rheumatoid arthritis

作　　者：孙驰 董晨 毛雪 顾淅淅 赵睿 顾志峰[1] Sun Chi;Dong Chen;Mao Xue;Gu Xixi;Zhao Rui;Gu Zhifeng(Affiliated Hospital of Nantong University,Nantong University,Nantong 226001,China)

机构地区：[1]南通大学附属医院,南通226001

出　　处：《中华老年医学杂志》2023年第1期46-51,共6页Chinese Journal of Geriatrics

基　　金：国家自然科学基金(编号:82101891、82071838);南通市科技项目(编号:JC2021119)。

摘　　要：目的探讨老年类风湿关节炎患者的淋巴细胞亚群与非老年患者的差异及意义。方法选取2017年1月至2019年12月在南通大学附属医院就诊的124例类风湿关节炎患者。患者根据年龄分为老年组(≥60岁,34例)和非老年组(<60岁,90例)。对患者进行类风湿性关节炎活动度(DAS-28)评分。Ficoll密度离心法提取外周血单个核细胞(PBMC),使用18色通道流式细胞仪,共30多种荧光抗体对淋巴细胞进行标记检测。结果DAS-28结果表明老年组的疾病活动度评分(4.56±1.89)大于非老年组(3.37±1.49)(t=3.633,P<0.001)。流式结果显示黏膜相关淋巴组织T细胞(MAIL%T)(Z=-2.798,P=0.005)、初始CD8 T细胞(Tn%CD8 T)(Z=-2.179,P=0.029)、vd2%T(Vδ2+T,γδT细胞的亚型)(Z=-2.806,P=0.005)、PD1-CD28-%Th(Z=-2.050,P=0.040)以及IGM+D-%B(Z=-2.376,P=0.017)在老年组中的表达低于非老年组,而CD45+CD27+%CD8 T(Z=-3.069,P=0.002)、abT%T(αβT细胞)(Z=-2.103,P=0.035)、CD27-CD28+%T(Z=-2.341,P=0.019)、ASC%PBMC(Z=-2.341,P=0.019)和ASC%CD19+(Z=-2.000,P=0.046)亚群在老年组中的表达要高于非老年组。结论老年类风湿关节炎患者的疾病活动度要明显高于较年轻的患者。老年类风湿关节炎较年轻患者的效应T细胞中的abT%T、CD4%abT的表达升高,而vd2%T的表达降低;具有细胞毒性作用的CD45RA+CD27+%CD8 T的表达水平较高;而初始样细胞的Tn%CD8 T的表达水平则较低。Objective To investigate the difference of lymphocyte subsets between elderly patients with rheumatoid arthritis and non-elderly patients and its clinical significance.Methods A total of 124 patients with rheumatoid arthritis in Affiliated Hospital of Nantong University from January,2017 to December,2019 were enrolled.The patients were divided into elderly group(≥60 years old,34 cases)and non-elderly group(<60 years old,90 cases).Rheumatoid arthritis activity(DAS-28)scoring was performed for each patient.Peripheral blood mononuclear cells(PBMCs)were extracted by Ficoll density centrifugation.Lymphocytes were labeled and detected by 18-color flowcytometry with more than 30 fluorescent antibodies.Results DAS-28 scoring showed that the disease activity score of the elderly group(4.56±1.89)was higher than that of the non-elderly group(3.37±1.49)(t=3.633,P<0.001).Flow cytometry showed that MAIL%T(mucus-associated lymphoid tissue T cell subset)(Z=-2.798,P=0.005),Tn%CD8 T cells(initial CD8 T cells)(Z=-2.179,P=0.029),VD2%T(Vδ2+T,γδT cell subtype)(Z=-2.806,P=0.005),PD1-CD28-%Th(Z=-2.050,P=0.040)and IGM+D-%B(Z=-2.376,P=0.017)were lower in the elderly group than in the non-elderly group.While,CD45+CD27+%CD8 T cells(Z=-3.069,P=0.002),abT%T cell(αβT cells)(Z=-2.103,P=0.035),CD27-CD28+%T cells(Z=-2.341,P=0.019),ASC%PBMC(Z=-2.341,P=0.019)and ASC%CD19+(Z=-2.000,P=0.046)subgroup expression were higher in the elderly group than in the non-elderly group.Conclusions The disease activity of elderly patients with rheumatoid arthritis is significantly higher than that of younger patients.The expressions of abT%T and CD4%abT in effector T cells of elderly patients with rheumatoid arthritis are higher than those of younger patients,while the expression of VD2%T is lower.The expression level of CD45RA+CD27+%CD8 T with cytotoxic effect is higher;However,the expression level of Tn%CD8 T in naive cells is lower.

关 键 词：类风湿关节炎 老年 外周血单个核细胞 淋巴亚群 

分 类 号：R593.22[医药卫生—内科学]