摘要
目的:观察类风湿关节炎患者免疫球蛋白的变化及新风胶囊(XFC)对其影响。方法:选取304例类风湿关节炎患者,检测血标本中免疫球蛋白Ig A、Ig G、Ig M含量,类风湿因子(RF)、C-反应蛋白(CRP)、红细胞沉降率(ESR)等炎症指标,并计算DAS28评分。同时,采用流式细胞术检测外周血Treg、BTLA表达频率。结果:(1)304例RA患者中有150例发生免疫球蛋白(Ig G或Ig A或Ig M)改变,发生率为49.34%。其中Ig G升高49例(16.12%),Ig A升高87例(28.62%),Ig M升高14例(4.61%)。(2)经过12周的治疗后,按照美国风湿病学会(ACR)制定的ACR20/50/70标准,XFC组与来氟米特(LEF)组疗效比较,差异无统计学意义(P>0.05)。(3)与治疗前比较,XFC组ESR、CRP水平明显降低,BTLA、Treg明显升高(P<0.05);与LEF组比较,XFC组BTLA升高较明显(P<0.01),其余各指标改变与LEF组比较,差异无统计学意义(P>0.05)。XFC组中,免疫球蛋白升高组治疗前后比较,其ESR、RF、CRP、Ig G、DAS28评分均明显改善(P<0.05);免疫球蛋白不升高组治疗前后比较,CRP明显降低(P<0.05),Ig G、Ig A均升高(P<0.05)。(4)相关性分析结果显示:RA患者外周血中Ig G与ESR、RF等疾病活动性指标、VAS、DAS28评分呈正相关,与BTLA、Treg呈负相关(P<0.05);Ig A与ESR、CRP、RF、抗CCP抗体呈正相关(P<0.05或P<0.01);Ig M与ESR、DAS28评分以及医师对疾病活动整体评估(VAS)呈正相关,与BTLA、Treg呈负相关(P<0.05)。结论:类风湿关节炎患者普遍存在免疫球蛋白水平的改变,并且XFC能够调节Treg、BTLA表达水平,从而进一步改善免疫球蛋白水平,调节类风湿关节炎患者的体液免疫。
Objective:To observe the changes of immunoglobulin in patients with rheumatoid arthritis and the effects of Xinfeng Capsule(XFC,新风胶囊)on them.Methods:Three hundred and four patients with rheumatoid arthritis were selected to detect the contents of immunoglobulin IgA,IgG and IgM,and inflammatory indexes of rheumatoid factor(RF),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR),and DAS28 was calculated.Meanwhile,the expression frequencies of Treg and BTLA in peripheral blood were detected by flow cytometry.Results:①Immunoglobulin(IgG or IgA or IgM)changed in 150 of 304 patients with RA,and the incidence rate was 49.34%.Among them,IgG increased in 49 cases(16.12%),IgA increased in 87 cases(28.62%),and IgM increased in 14 cases(4.61%).②After 12 weeks of treatment,there was no significant difference of curative effect between the XFC group and the leflunomide(LEF)group according to the ACR20/50/70 standard established by the American College for Rheumatology(ACR)(P>0.05).③Compared with before treatment,the levels of ESR and CRP in the XFC group decreased significantly,and BTLA and Treg increased significantly(P<0.05).Compared with the LEF group,the BTLA of the XFC group increased significantly(P<0.01),and the other indexes were not significantly different from those in the LEF group(P>0.05).In group XFC,the ESR,RF,CRP,IgG and DAS28 were significantly improved before and after treatment in the elevated immunoglobulin group(P<0.05);CRP decreased significantly(P<0.05),and IgG and IgA increased(P<0.05)before and after the treatment in the group without elevation of immunoglobulin.④The results of the correlation analysis showed that IgG was positively related to ESR,RF,VAS and DAS28 in peripheral blood of RA patients,and negatively correlated with BTLA and Treg(P<0.05);IgA was positively correlated with ESR,CRP,RF,and Anti CCP antibody(P<0.05 or P<0.01);and IgM was positively correlated ESR,DAS28 and VAS,and negatively correlated with BTLA and Treg(P<0.05).Conclusion:The level of immunoglobulin
作者
章平衡
刘健
万磊
孙玥
ZHANG Ping-heng;LIU Jian;WAN Lei;SUN Yue
出处
《风湿病与关节炎》
2018年第7期10-16,共7页
Rheumatism and Arthritis
基金
国家自然科学基金(81173211)
国家科技支撑计划课题(2012BA126B02)
国家中医药重点学科中医痹病学建设项目(国中医药发[2009]30号)
国家临床重点学科中医风湿病科建设项目(财社[2013]239号)
安徽省重点实验室建设项目(1306c083035)
关键词
关节炎
类风湿
免疫球蛋白
新风胶囊
arthritis,rheumatoid
immunoglobulin
Xinfeng Capsule(新风胶囊)
