类风湿关节炎患者英夫利西单抗治疗后T淋巴细胞变化及临床意义  

Changes and clinical significance of T lymphocytes in patients with rheumatoid arthritis after infliximab treatment

作　　者：王雯婧[1] 孟新艳[1] 武丽君[1] WANG Wenjing;MENG Xinyan;WU Lijun(Department of Rheumatology and Immunology,The People's Hospital of Xinjiang Uygur Autonomous Region,Clinical Research Center for Rheumatoid Arthritis of Xinjiang,Urumqi,830001,China)

机构地区：[1]新疆维吾尔自治区人民医院风湿免疫科,新疆类风湿关节炎临床医学研究中心,乌鲁木齐830001

出　　处：《新疆医学》2025年第1期28-32,共5页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区重点研发项目(项目编号:2022B03002-1)。

摘　　要：目的 探讨类风湿关节炎(Rheumatoid Arthritis,RA)患者英夫利西单抗治疗前后T淋巴细胞亚群变化及临床意义。方法 研究纳入2019年3月至2021年6月就诊的27例中重度活动期并接受英夫利西单抗治疗的RA患者,及同期22例健康对照者,每位RA患者在第0,2,6,14,22周接受英夫利西单抗治疗每次3mg/kg,在第0(组A),14(组B),30(组C)周检测外周血T淋巴细胞。进行统计分析。结果 1.RA各组总T淋巴细胞计数、组A CD3^(+)CD4^(+)T计数、组A和组B CD3^(+)CD8^(+)T计数与对照组比较,差异均有统计学意义(P<0.05)。2.RA各组CD4^(+)T%、CD8^(+)T%、CD4^(+)CD8^(+)T%与对照组比较,差异无统计学意义(P>0.05)。3.组A、组B CD4^(+)/CD8^(+)与对照组比较,差异有统计学意义(P<0.05)。结论 RA患者总T淋巴细胞计数、CD3^(+)CD4^(+)T计数、CD3^(+)CD8^(+)T计数、CD4^(+)CD8^(+)T计数减低,尤其在疾病活动状态下。淋巴细胞计数在RA中处于异常表达状态,对疾病诊断及疾病活动度均有一定的临床意义。中重度活动的RA患者CD4^(+)/CD8^(+)比值升高,CD4^(+)/CD8^(+)淋巴细胞比值失衡可能在活动期RA的发病中发挥了重要作用。Objective To investigate the changes of T lymphocyte subsets of patients with active rheumatoid arthritis(RA)before and after treatment with infliximab and its clinical significance.Methods A total of 27 RA patients who were treated with infliximab from March 2019 to June 2021,and 22 healthy control patients in the same period were enrolled.Each RA patient was treated with3mg/kg at week 0,2,6,14 and 22.T lymphocyte subsets in peripheral blood were detected at 0(group A),14(group B)and 30(group C)weeks,and statistical analysis was performed.Results 1.The total T Lymphocyte count in RA group,CD3^(+)CD4^(+)T count of group A,CD3^(+)CD8^(+)T count in group A and B were statistically significant compared with the control group(P<0.05).2.There was no significant difference in the percentage of CD4^(+)T,CD8^(+)T or CD4^(+)CD8^(+)T between RA groups and control group(P>0.05).3.The difference of CD4+/CD8+between group A and group B was statistically significant(P<0.05).Conclusion The total T lymphocyte count,CD3^(+)CD4^(+)T,CD3^(+)CD8^(+)T and CD4^(+)CD8^(+)T decreased in patients with RA,especially in the active state of disease.Lymphocyte count is abnormally expressed in RA,which has certain clinical significance for disease diagnosis and disease activity.The CD4^(+)/CD8^(+)ratio increased in moderate and severe active RA patients,and the imbalance of CD4^(+)/CD8^(+)Lymphocyte ratio may play an important role in the pathogenesis of active RA.

关 键 词：类风湿关节炎 T淋巴细胞亚群 英夫利西单克隆抗体 

分 类 号：R456[医药卫生—治疗学]