摘要
目的:观察类风湿关节炎(RA)患者的情志状态变化及与疾病临床指标间的相关性。方法:选取604例RA患者(RA组),并设60例健康对照组。采用问卷调查方式记录患者健康状况评估问卷(HAQ)、抑郁自评量表(SDS)和焦虑自评量表(SAS)积分,评估其焦虑抑郁状态。同时,采用流式细胞术检测外周血调节性T细胞(Treg),B、T淋巴细胞衰减因子(BTLA)表达频率,测定红细胞沉降率(ESR)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、C-反应蛋白(CRP)、类风湿因子(RF)、抗环瓜氨酸肽(CCP)抗体等指标,并计算疾病活动性评分(DAS28)。结果:1与健康对照组相比,RA组超过70%的患者存在HAQ、SDS、SAS积分异常,具体表现为患者HAQ、SDS、SAS积分明显升高;同时炎性指标ESR、CRP等升高,免疫指标BTLA、Treg等的表达频率降低。2相关性分析显示,RA组患者HAQ积分值与ESR、RF、IgG、BTLA、Treg呈正相关;SDS积分值与ESR、CRP、RF、IgG、BTLA、Treg呈负相关,与抗CCP抗体、IgM呈正相关;SAS积分值与ESR、IgG呈正相关,与抗CCP抗体、BTLA、Treg呈负相关。结论:RA患者普遍存在焦虑抑郁等情志障碍,并与疾病活动度及免疫功能失调密切相关,是RA疾病活动及免疫功能紊乱的一个具体体现。
Objective：To observe the emotional changes of patients with rheumatoid arthritis （ RA ） and their correlation with clinical indicators.Methods：There are two groups in the study：the RA group （ 604 patients with RA ） and a healthy control group （ 60 healthy people ） .Questionnaire survey was used to record the scores of health assessment questionnaire （ HAQ ） ,self rating depression scale （ SDS ） and self rating anxiety scale （ SAS ） to assess the status of anxiety and depression.At the same time,flow cytometry was used to detect the expression frequency of peripheral blood regulatory T cells （ Treg ） and B and T lymphocyte attenuator （ BTLA ） ,and to made a determination of indexes of erythrocyte sedimentation rate （ ESR ） ,immunoglobulin G （ IgG ） ,immunoglobulin M （ IgM ） ,C- reactive protein （ CRP ） ,rheumatoid factor （ RF ） and anti cyclic citrullinated peptide （ CCP ） antibody, calculating the disease activity score （ DAS28 ） .Results： （1） Compared with the healthy control group,more than 70% patients in the RA group had HAQ,SDS and SAS integral anomaly：the higher scores of HAQ,SDS and SAS,the higher inflammatory indexes of ESR and CRP and the decrease of expression frequency of BTLA and Treg. （2） Correlation analysis showed that in the RA group the HAQ scores were positively correlated with ESR, RF, IgG,BTLA and Treg;SDS scores were negatively correlated with ESR,CRP, RF, IgG,BTLA,and Treg and positively correlated with anti CCP antibody and IgM;and SAS scores were positively correlated with ESR and IgG and negatively correlated with anti CCP antibody, BTLA and Treg.Conelusion：Many RA patients have anxiety and depression associated with disease activity and disorder of immune function,which is a concrete manifestation of RA.
出处
《风湿病与关节炎》
2016年第9期9-15,共7页
Rheumatism and Arthritis
基金
"十二五"国家科技支撑计划项目(2012BAI26B02)
国家自然科学基金(81173211)
安徽省科技厅科技攻关项目(09020304046)
关键词
关节炎
类风湿
焦虑抑郁情绪
相关性分析
arthritis,rheumatoid
anxiety and depression
correlation analysis
