【摘要】：目的:本實(shí)驗(yàn)擬采用流式細(xì)胞術(shù)(FCM)和酶聯(lián)免疫吸附(ELISA)的方法分別檢測類風(fēng)濕關(guān)節(jié)炎(RA)患者外周血單個(gè)核細(xì)胞(PBMC)和關(guān)節(jié)液中CD4+CXCR5+T細(xì)胞的表達(dá)以及相關(guān)細(xì)胞因子白細(xì)胞介素(IL)-21的表達(dá),探討濾泡輔助性T細(xì)胞(Tfh)在類風(fēng)濕關(guān)節(jié)炎發(fā)病機(jī)制中的作用。方法:采集RA病人和對照組(骨關(guān)節(jié)炎患者)外周血、關(guān)節(jié)液,流式細(xì)胞術(shù)檢測外周血及關(guān)節(jié)液中CD4+CXCR5+T細(xì)胞的百分比;血清及關(guān)節(jié)液中IL-21蛋白的水平用酶聯(lián)免疫吸附法(ELISA法)檢測。結(jié)果:RA組活動(dòng)期及緩解期外周血單個(gè)核細(xì)胞中Tfh細(xì)胞百分率(14.15%±2.74%,12.80%±2.15%)均明顯高于對照組(7.26%±1.62%)(P0.05),活動(dòng)期與緩解期組間比較,差異無統(tǒng)計(jì)學(xué)意義;RA組活動(dòng)期及緩解期IL-21水平(41.88±15.63pg/ml,37.27±11.44pg/ml)均明顯高于對照組(22.25±1.18)pg/ml(P0.05),RA組中活動(dòng)期與緩解期組間比較,差異無統(tǒng)計(jì)學(xué)意義;RA組活動(dòng)期關(guān)節(jié)液Tfh細(xì)胞陽性表達(dá)率(3.15%±1.42%)與對照組關(guān)節(jié)液Tfh細(xì)胞陽性表達(dá)率(2.88%±1.17%)相比,差異無統(tǒng)計(jì)學(xué)意義;RA組活動(dòng)期關(guān)節(jié)液中IL-21蛋白水平(37.92±15.49)pg/ml與對照組關(guān)節(jié)液IL-21蛋白水平(34.31±5.15)pg/ml相比,差異無統(tǒng)計(jì)學(xué)意義。RA患者外周血中Tfh細(xì)胞百分比、IL-21水平與抗環(huán)瓜氨酸肽抗體(An-CCP)、類風(fēng)濕因子(RF)均呈正相關(guān)結(jié)論:Tfh細(xì)胞可能啟動(dòng)了RA的發(fā)病過程,但對疾病活動(dòng)未見明顯促進(jìn)作用;IL-21可能并非為啟動(dòng)RA疾病活動(dòng)的主要因素。
[Abstract]:Objective: flow cytometry (FCM) and enzyme-linked immunosorbent assay (Elisa) were used to detect the expression of CD4 CXCR5 T cells and cytokines in peripheral blood mononuclear cells (PBMC) and joint fluid of patients with rheumatoid arthritis (RA). Expression of interleukin (IL) -21, To investigate the role of follicular helper T cells (Tfh) in the pathogenesis of rheumatoid arthritis. Methods: peripheral blood and joint fluid were collected from RA patients and controls (osteoarthritis patients). The percentage of CD4 CXCR5 T cells in peripheral blood and joint fluid were detected by flow cytometry. The level of IL-21 protein in serum and joint fluid was detected by enzyme linked immunosorbent assay (Elisa). Results the percentage of Tfh cells in the peripheral blood mononuclear cells in the active phase and remission phase of the control group (14.15% 鹵2.74 鹵12.80% 鹵2.15%) was significantly higher than that in the control group (7.26% 鹵1.62%) (P0.05). The level of IL-21 in RA group (41.88 鹵15.63pg / ml, 37.27 鹵11.44pg/ml) was significantly higher than that in control group (22.25 鹵1.18) pg/ml (P0.05). The positive expression rate of Tfh cells in active synovial fluid (3.15% 鹵1.42%) in RA group was higher than that in control group (2.88% 鹵1.17%). The level of IL-21 protein in active synovial fluid of RA group was (37.92 鹵15.49) pg/ml and that in control group was (34.31 鹵5.15) pg/ml. There was no significant difference in the percentage of Tfh cells in peripheral blood of RA patients. The level of IL-21 was positively correlated with anti-cyclic citrullin-peptide antibody (An-CCP) and rheumatoid factor (RF). But there was no obvious effect on disease activity. IL-21 may not be the main factor to initiate RA disease activity.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R593.22

【參考文獻(xiàn)】

相關(guān)期刊論文 前8條

1 崔冉;徐建華;;類風(fēng)濕關(guān)節(jié)炎患者外周血輔助性T細(xì)胞9及白細(xì)胞介素-9的變化及臨床意義[J];中華風(fēng)濕病學(xué)雜志;2012年07期

2 陳俊偉;張少然;閆成蘭;謝戩芳;呂志勤;羅靜;李小峰;;T輔助細(xì)胞亞型細(xì)胞相關(guān)因子在類風(fēng)濕關(guān)節(jié)炎發(fā)病中的作用[J];中國藥物與臨床;2012年04期

3 于月紅;孫海玲;錢雷;;類風(fēng)濕關(guān)節(jié)炎患者外周血Th17細(xì)胞的檢測及其臨床意義[J];檢驗(yàn)醫(yī)學(xué)與臨床;2011年13期

4 劉伯讓;楊U，

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