强直性脊柱炎患者外周血不同类型单核细胞极化与病情严重程度的关系  

The relationship between the polarization of monocytes in peripheral blood and the disease severity of AS patients

作　　者：于翱瑞 曹亚飞[2] 林文平 高坤 张少群 李伟[1] 覃国忠 霍青云 曾凡宇 张芸[4] Yu Ao-rui;Cao Ya-fei;Lin Wen-ping;Gao Kun;Zhang Shao-qun;Li Wei;Qin Guo-zhong;Huo Qing-yun;Zeng Fan-yu;Zhang Yun(Department of Orthopedics,Shenzhen Pingle Orthopedics and Traumatology Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine(Shenzhen Pingshan District Traditional Chinese Medicine Hospital),Shenzhen,Guangdong 518000,China;Department of Orthopedics and Traumatology,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen,Guangdong 518118,China;Department of Spinal Surgery,Shenzhen Pingle Orthopedics and Traumatology Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine(Shenzhen Pingshan District Traditional Chinese Medicine Hospital),Shenzhen,Guangdong 518000,China;Department of Quality Control,Shenzhen Pingle Orthopedics and Traumatology Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine(Shenzhen Pingshan District Traditional Chinese Medicine Hospital),Shenzhen,Guangdong 518000,China)

机构地区：[1]广州中医药大学附属深圳平乐骨伤科医院(深圳市坪山区中医院)正骨科,广东深圳518000 [2]深圳市中医院骨伤科,广东深圳518118 [3]广州中医药大学附属深圳平乐骨伤科医院(深圳市坪山区中医院)脊柱科,广东深圳518000 [4]广州中医药大学附属深圳平乐骨伤科医院(深圳市坪山区中医院)质控科,广东深圳518000

出　　处：《中国现代医学杂志》2023年第24期74-79,共6页China Journal of Modern Medicine

基　　金：广东省自然科学基金面上项目(No:2021A1515010722);广东省中医药局科研项目(No:20221355);深圳市科技计划项目(No:JCYJ20210324111205015)。

摘　　要：目的 探讨强直性脊柱炎(AS)患者外周血不同类型单核细胞极化与病情严重程度的关系。方法 选取2020年1月—2021年12月广州中医药大学附属深圳平乐骨伤科医院收治的AS患者71例(AS组),以及年龄、性别基本匹配的体检志愿者80例作为对照组。采用流式细胞术检测CD36^(+)、CD206^(+)、CD68^(+),分析不同类型单核细胞与脊柱结构破坏指数的相关性,并对比患者治疗前后不同类型单核细胞的变化。结果 AS组C反应蛋白(CRP)、血沉(ESR)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平高于对照组(P <0.05)。AS组外周血CD36^(+)、CD206^(+)细胞比例低于对照组(P <0.05),CD68^(+)细胞比例高于对照组(P <0.05)。CD36^(+)、CD206^(+)与强直性脊柱炎疾病活动指数(BASDAI)评分、Bath强直性脊柱炎功能指数(BASFI)评分均呈负相关(P <0.05),CD68^(+)与BASDAI评分、BASFI评分均呈正相关(P <0.05)。AS患者治疗后CRP、ESR、IgG、IgM、IgA、TNF-α、IL-6水平较治疗前均降低(P <0.05)。AS患者治疗后CD36^(+)、CD206^(+)细胞比例较治疗前升高,CD68^(+)细胞比例及BASDAI评分、BASFI评分较治疗前降低。结论 AS患者外周血CD36^(+)、CD206^(+)细胞比例降低、CD68^(+)细胞比例升高与疾病严重程度有一定的关系。Objective To investigate the relationship between different types of monocyte polarization in peripheral blood and the disease severity of patients with ankylosing spondylitis(AS).Methods From January 2020 to December 2021,a total of 71 AS patients(AS group)and 80 age-and sex-matched volunteers undergoing health checkup(control group)in Shenzhen Pingle Orthopedics and Traumatology Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine were selected.Flow cytometry was performed to detect the proportions of CD36^(+),CD206^(+),and CD68^(+)monocytes,and the correlations between distinct subsets of monocytes and the disease activity indexes were analyzed.The changes of the different types of monocytes before and after treatment were determined.Results The levels of CRP,ESR,IgG,IgM,IgA,TNF-α,and IL-6 in the AS group were significantly higher than those in the control group(P<0.05).Compared with the control group,the proportions of CD36^(+)and CD206^(+)cells in peripheral blood were significantly lower but the proportion of CD68^(+)cells in peripheral blood was higher in the AS group(P<0.05).The proportions of CD36^(+)and CD206^(+)cells were negatively correlated with BASDAI scores and BASFI scores(P<0.05),and the proportion of CD68^(+)cells was positively correlated with BASDAI scores and BASFI scores(P<0.05).The levels of CRP,ESR,IgG,IgM,IgA,TNF-αand IL-6 after the treatment were significantly lower than those before the treatment in AS patients(P<0.05).The proportions of CD36^(+)and CD206^(+)cells after the treatment were increased compared with those before the treatment(P<0.05),while the proportion of CD68^(+)cells,BASDAI scores and BASFI scores after the treatment were decreased compared with those before the treatment in AS patients(P<0.05).Conclusions The decreased proportions of CD36^(+)and CD206^(+)monocytes and the increased proportion of CD68^(+)monocytes in the peripheral blood of AS patients are related to the severity of the disease.

关 键 词：强直性脊柱炎 单核细胞 脊柱结构破坏指数 炎症指标 

分 类 号：R593.23[医药卫生—内科学]