外周血辅助性T细胞对类风湿关节炎患者共病心血管疾病的预测价值  

The predictive value of peripheral blood T-helper cells in patients with rheumatoid arthritis comorbid cardiovascular disease

作　　者：吕志文 万鲁云 桂春喜 Lyu Zhiwen;Wan Luyun;Gui Chunxi(Department of Clinical Laboratory,Honghu Hospital of Traditional Chinese Medicine,Honghu 433200,China)

机构地区：[1]洪湖市中医医院检验科,洪湖433200

出　　处：《中国医师进修杂志》2024年第10期931-935,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨类风湿关节炎(RA)患者外周血辅助性T细胞(Th17)、调节性T细胞(Treg)以及Th17/Treg比值对RA共病心血管疾病的预测价值。方法回顾性选取2022年1月至2023年1月洪湖市中医医院收治的180例RA患者,按照是否共病心血管疾病分为共病组(72例)和单纯RA组(108例),收集两组患者一般资料,采用流式细胞术检测外周血Th17、Treg水平,并计算Th17/Treg比值。应用二元Logistic回归分析RA共病心血管疾病的危险因素,应用受试者工作特征(ROC)曲线分析Th17、Treg及Th17/Treg比值对RA共病心血管疾病的预测价值。结果共病组男性占比、尿酸、Th17、Th17/Treg比值高于单纯RA组[63.89%(46/72)比44.44%(48/108)、350.00(288.00,404.50)μmol/L比316.00(257.50,382.50)μmol/L、(11.28±4.22)%比(6.60±2.98)%、3.55±6.53比1.48±2.54],Treg低于单纯RA组[(5.10±2.19)%比(6.75±2.86)%],差异有统计学意义(P<0.05)。二元Logistic回归分析结果显示,Th17和Th17/Treg比值增加是RA共病心血管疾病的危险因素,Treg增加是RA共病心血管疾病的保护因素(均P<0.05)。Th17、Th17/Treg预测RA共病心血管疾病的曲线下面积(AUC)分别为0.814和0.785,Th17预测RA共病冠心病、缺血性脑卒中、外周动脉粥样硬化疾病的AUC分别为0.804、0.832、0.784,Th17/Treg预测的AUC分别为0.763、0.792、0.883。结论Th17、Treg、Th17/Treg是RA共病心血管疾病的可能影响因素,且Th17、Th17/Treg对RA共病心血管疾病有一定预测价值。Objective To analysis the predictive value of peripheral blood T-helper cells(Th17),regulatory T cells(Treg)and Th17/Treg in patients with rheumatoid arthritis(RA)comorbid cardiovascular disease.Methods A total of 180 RA patients treated in Honghu Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were selected retrospectively,they were divided into comorbidity group(72 cases)and RA group(108 cases)according to whether they had cardiovascular disease.The general data of patients were collected,the levels of peripheral blood Th17,Treg were measured by flow cytometry,the Th17/Treg ration was calculated.The risk factors of RA comorbid cardiovascular disease were analyzed by binary Logistic regression,and the predictive value of Th17 and Treg for RA comorbid cardiovascular disease was analyzed by the receiver operating characteristic(ROC)curve.Results The levels of male proportion,uric acid,Th17,Th17/Treg ratio were increased,and Treg were decreased in the comorbidity group compared to the RA group:63.89%(46/72)vs.44.44%(48/108),350.00(288.00,404.50)μmol/L vs.316.00(257.50,382.50)μmol/L,(11.28±4.22)%vs.(6.60±2.98)%,3.55±6.53 vs.1.48±2.54,(5.10±2.19)%vs.(6.75±2.86)%,there were statistical differences(P<0.05).Binary Logistic regression analysis showed that Th17 and Th17/Treg ratio were risk factors for RA comorbid cardiovascular disease,and Treg cell ratio was a protective factor for RA comorbid cardiovascular disease(all P<0.05).The area under the curve(AUC)predicted by Th17 and Th17/Treg for RA comorbid cardiovascular disease were 0.814 and 0.785,respectively.The AUC predicted by Th17 for RA comorbid coronary heart disease,ischemic stroke and peripheral atherosclerosis were 0.804,0.832,and 0.784,respectively.The AUC predicted by Th17/Treg for RA comorbid coronary heart disease,ischemic stroke and peripheral atherosclerosis were 0.763,0.792,and 0.883,respectively.Conclusions Th17,Treg and Th17/Treg are the possible influencing factors of RA comorbid cardiovascular disease,and Th17,Th17/

关 键 词：关节炎 类风湿 心血管疾病 T淋巴细胞 因素分析 统计学 

分 类 号：R593.22[医药卫生—内科学] R54[医药卫生—临床医学]