急性痛风性关节炎患者外周血脂联素与CD4^(+)T细胞亚群的分析及相关性研究  

Analysis and Correlation between Peripheral Adiponectin and CD4^(+)T Cell Subsets in Patients with Acute Gouty Arthritis

作　　者：王颖[1] 高惠英[1] 张琪 尚莉丽 范春雪 罗静[1] 王彩虹[1] WANG Ying;GAO Huiying;ZHANG Qi(Department of Rheumatology,Second Hospital of Shanxi Medical University,Shanxi 030001,China)

机构地区：[1]山西医科大学第二医院风湿免疫科,太原030001

出　　处：《医学研究杂志》2024年第2期96-100,共5页Journal of Medical Research

基　　金：山西省重点研发计划项目(201803D31130)。

摘　　要：目的比较急性痛风性关节炎患者与健康对照组外周血脂联素及CD4+T细胞亚群的差异,并探究痛风患者脂联素与血尿酸、疾病活动度、CT4^(+)T细胞亚群及部分细胞因子的相关性。方法收集急性痛风组(n=90)及健康对照组(n=72)的临床资料(包括一般资料、中性粒细胞、红细胞沉降率、C反应蛋白、血尿酸、CT4^(+)T细胞亚群及部分细胞因子);检测两组外周血脂联素水平,比较两组间外周血脂联素及CD4+T细胞亚群的差异;分析脂联素与各临床资料的相关性。结果与健康对照组比较,急性痛风组外周血脂联素水平明显降低(P<0.001),且Th2、Th17、Th17/Treg均升高(P<0.05),Treg、Th1/Th2均降低(P<0.05)。急性痛风组外周血脂联素与中性粒细胞、红细胞沉降率及C反应蛋白均呈负相关(r=-0.244,P<0.05;r=-0.311,P<0.05;r=-0.506,P<0.001),而与血尿酸无相关性。急性痛风组外周血脂联素与Th1和Th1/Th2均呈正相关(r=0.252,P<0.05;r=0.218,P<0.05)。急性痛风组外周血脂联素与白细胞介素-2(interleukin-2,IL-2)、白细胞介素-4(interleukin-4,IL-4)和白细胞介素-10(interleukin-10,IL-10)均呈正相关(r=0.323,P<0.05;r=0.377,P<0.05;r=0.359,P<0.05);而与白细胞介素-6(interleukin-6,IL-6)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)呈负相关(r=-0.265,P<0.05;r=-0.299,P<0.05)。多元线性回归分析显示,急性痛风组外周血脂联素与红细胞沉降率、C反应蛋白、IL-6及TNF-α均呈负相关(B _(ESR)=-12.541,P=0.003;B_( CRP)=-8.256,P=0.024;B_( IL-6)=-15.907,P=0.037;B _(TNF-α)=-79.770,P=0.040),而与Th1呈正相关(B _(Th1)=2.959,P=0.006)。结论急性痛风性关节炎患者外周血脂联素水平降低,Th2和Th17升高,而Treg降低,脂联素降低与急性痛风性关节炎患者免疫紊乱及免疫炎症相关。Objective To compare the difference of peripheral blood adiponectin and CD4+T cell subsets between patients with acute gouty arthritis and healthy controls,to explore the correlation between adiponectin and serum uric acid,disease activity,CT4^(+)T cell subsets and some cytokines in patients with gout.Methods The clinical data(including general data,neutrophils,erythrocyte sedimentation rate,C-reactive protein,blood uric acid,CT4^(+)T cell subsets and some cytokines)of acute gout group(n=90)and healthy control group(n=72)were collected.The level of adiponectin in peripheral blood of two groups were detected,and the differences of adiponectin and CD4^(+)T cell subsets between the two groups were compared;the correlation between adiponectin and clinical data was analyzed.Results The levels of serum adiponectin in the acute gout group were significantly lower than those in the healthy control group(P<0.001),and the levels of Th2,Th17,Th17/Treg were significantly higher than those in the healthy control group(P<0.05),while the levels of Treg and Th1/Th2 were significantly lower than those in the healthy control group(P<0.05).In the acute gout group,adiponectin was negatively correlated with neutrophil,erythrocyte sedimentation rate and C-reactive proten(r=-0.244,P<0.05;r=-0.311,P<0.05;r=-0.506,P<0.001),there was no correlation with serum uric acid.In acute gout group,adiponectin was positively correlated with Th1 and Th1/Th2(r=0.252,P<0.05;r=0.218,P<0.05).In acute gout group,adiponectin in peripheral blood was positively correlated with interleukin-2(IL-2),interleukin-4(IL-4)and interleukin-10(IL-10)(r=0.323,P<0.05;r=0.377,P<0.05;r=0.359,P<0.05).There was a negative correlation between interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)(r=-0.265,P<0.05;r=-0.299,P<0.05).Multiple linear regression analysis showed that adiponectin in the acute gout group was negatively correlated with erythrocyte sedimentation rate,C-reactive protein,IL-6 and TNF-α(B _(ESR)=-12.541,P=0.003;B _(CRP)=-8.256,P=0.024;B _(IL-6)=-15.907,

关 键 词：痛风 关节炎 脂联素 CD4^(+)T细胞亚群 细胞因子 

分 类 号：R589.7[医药卫生—内分泌]