摘要
目的:探讨类风湿关节炎心肺功能变化进行研究,并分析类风湿关节炎心肺功能变化与氧化应激及外周血淋巴细胞衰减因子的相关性。方法:以130例住院类风湿关节炎患者为病例组研究对象,50例健康体检为正常对照。分别检测两组入选对象心功能参数EF%、SV%、FS%、E、A、E/A;肺功能参数FVC、FEV1、MVV、PEF;B、T淋巴细胞衰减因子表达频率及相关活化水平;酶联免疫吸附法检测外周血细胞因子(IL-17、TNF-α、IL-4、IL-35)及氧化应激指标(MDA、ROS、SOD、TAOC)。结果:病例组研究对象心功能各项指标明显低于正常对照组。病例组130例患者中,有103例心功能指标异常,占病例组研究对象的79.23%,而E/A异常率最高。病例组与正常对照组相比,LADd增厚,A峰升高,EF、E峰、E/A降低,相比差异有统计学意义(P<0.05);与正常对照组相比,病例组肺功能各项参数明显降低;病例组130例患者中,有88例肺功能指标异常,占病例组研究对象的67.69%。而其中PEF异常率最高。病例组肺功能各项指标明显低于对照组,相比差异有统计学意义(P<0.05);相关分析显示心功能指标EF与CD24^+细胞和CD19^+CD24^+细胞的相关系数分别为-0.353及-0.457,具有负相关性,与ROS的相关系数为0.459,具有正相关性。心功能指标FS与CD24^+细胞、CD19^+CD24^+细胞的相关系数为-0.395和-0.421,具有负相关性;A峰与CD19^+cell的相关系数为0.423,具有正相关性,E/A与BTLA的相关系数为0.393,具有明显的正相关性;SV与MDA、SOD呈正相关;肺功能的各项参数均与Hs-CRP及ESR呈明显的负相关;肺功能参数FVC与BTLA及CD19^+CD24^+的相关系数0.513和0.596,具有明显正相关性,与CD24^+BTLA^+、TNF-α的相关系数为-0.451和-0.351,呈明显负相关性;参数FEV1与CD19^+CD24^+、TAOC、IL-4的相关系数分别为0.535、0.466及0.519,呈明显正相关性,与CD24^+BTLA^+、MDA的相关系数为-0.461和-0.358,呈明显负相关性;PEF与SOD、TAOC、IL-4、IL-35的相关系数分别为0.547、0.482、0.643及0.452,呈明显正相关性,与MDA、ROS、IL-17的相关系数为-0.451、-0.423及-0.417,呈明显负相关性(P<0.05)。结论:RA氧化应激失衡及细胞免疫失调贯穿于心肺功能损伤的整个过程,因此,在临床上治疗RA患者关节症状的同时,要探讨如何恢复机体氧化还原稳态,以上调BTLA水平,活化B、T细胞,从而抑制免疫炎症反应,降低心肺功能损伤。
Objective：To study the changes of cardiopulmonary function in patients with rheumatoid arthritis,and to analyze the correlation between the changes ofcardiopulmonary function with oxidative stress and the peripheral blood lymphocyte attenuation factor.Methods：130 cases of patients with rheumatoid arthritis were studied as case group,and 50 cases of healthy persons were studied as normal control group.Detected the heart function parameters of two groups,which contained EF%,SV%,FS%,E A,E/A;lung function parameters of FVC,FEV1,MVV,PEF;B and T lymphocyte attenuation factor expression and activation level.Peripheral Cytokine（IL-17 and TNF-α,IL-4,IL-35） and oxidative stress index（ROS,MDA,SOD,TAOC） were detected by enzyme linked immunosorbent assay.Results：The indexes of cardiac function in the case group were significantly lower than that in the control group.103 cases had abnormal cardiac function index in the case group,which accounted for 79.23% of the case group,while the E/A had the highest abnormal rate.The case group had thickening of LADd,increasing of peak A,decreasing of EF,E peak and E/A,than the normal control group,the differences were statistically significant（P 〈0.05）.Compared with normal control group,pulmonary function parameters were significantly lower in case group.88 cases of case group had abnormal pulmonary function,accounting for 67.69% of thecase group.Among them,the abnormal rate of PEF was the highest.Pulmonary function indexes of case group was significantly lower than that of the control group,the difference was statistically significant（P 0.05）.Correlation analysis showed that the correlation coefficient of cardiac function indexes EF with CD24＋cells and CD19＋CD24＋cells were respectively-0.353 and-0.457,which had negative correlation,with ROS the correlation coefficient was 0.459,which had positive correlation.The correlation coefficient of the cardiac function indexes in FS with CD24＋cells,and CD19＋CD24＋cells was-0.395 and-0.421,which had negative correlation;the correlation coefficient of peak A and CD19＋cell was 0.423,which had positive correlation;the correlation coefficient of E/A and BTLA was 0.393,which had obvious positive correlation.SV and MDA,SOD were positively correlated.The parameters of lung function with hs-CRP and ESR had significantly negative correlation.The correlation coefficient of lung function parameters FVC with BTLA and CD19＋CD24＋were 0.513 and 0.596,which had a significant positive correlation,with the correlation coefficient and CD24＋BTLA＋,TNF-α were-0.451 and-0.351,which had significantly negative correlation.The correlation coefficients of FEV1 with CD24＋CD19＋,TAOC and IL-4 were 0.535,0.466 and 0.519,which showed a positive correlation,with CD24＋BTLA＋,MDA were-0.461and-0.358,which had significantly negative correlation.The correlation coefficient of PEF with SOD,TAOC,IL-4,IL-35 were 0.547,0.482,0.643 and 0.452,which had significantly positive correlation,with MDA,ROS,IL-17 were-0.451,-0.423 and-0.417,which had a significant negative correlation（P〈0.05）.Conclusion：RA imbalance of oxidative stress and cell immune disorders which runs through the whole process in the heart and lung injury.Therefore,in clinical treatment,treatment of joint symptoms in RA patients needs restore the body＇s redox homeostasis,in order to increase the level of BTLA,activate B cell and,T cell,thereby inhibiting immune and inflammatory response,reducing the heart and lung function impairment.
出处
《中国免疫学杂志》
CAS
CSCD
北大核心
2016年第9期1364-1368,共5页
Chinese Journal of Immunology
关键词
类风湿关节炎
心、肺功能
B、T淋巴细胞衰减因子
氧化应激
Rheumatoid arthritis
Cardiopulmonary function
B
T lymphocyte attenuation factor
Oxidative stress
