摘要
目的检测类风湿关节炎(RA)患者外周血单核细胞亚型分布和功能分子表达水平,分析上述指标与RA发病相关性。方法收集2020年6月至2021年12月在同济大学附属东方医院就诊或体检的62例RA患者(RA组)、52名健康对照者(HC组)和12例疾病对照患者(疾病对照组),采集外周血,密度梯度离心法分离单个核细胞,单核细胞可分为经典型(CM)、中间型(IM)和非经典型(NCM),流式细胞术分析单核细胞亚型分布、人白细胞DR抗原(HLA-DR)的表达以及胞内肿瘤坏死因子α(TNF-α)的表达水平。采用Kruskal-WallisH检验、χ^(2)检验、Mann-WhitneyU检验、Wilcoxon配对符号秩检验、Spearman相关系数检验和Logistic回归分析进行统计学分析。采用ROC曲线分析IM比例对RA的诊断价值。结果 RA组[0.40(0.40,0.50),7.60%(5.97%,8.53%)]和疾病对照组[0.40(0.40,0.68),8.20%(5.85%,10.28%)]的单核细胞绝对值和占白细胞百分比均高于HC组[0.30(0.30,0.40),5.80%(5.03%,6.38%)],差异均有统计学意义(H=24.733,P<0.001;H=27.469,P<0.001)。RA组、HC组、疾病对照组的CM[85.49%(76.91%,89.21%),88.94%(86.36%,91.72%),90.26%(80.25%,92.56%)]、IM[11.65%(8.47%,17.89%),7.89%(5.36%,10.75%),5.56%(4.17%,8.27%)]和NCM[2.22%(1.39%,3.74%),2.49%(1.74%,4.66%),5.13%(3.39%,9.85%)]占比均有差异(H=11.389,P=0.003;H=20.815,P<0.001;H=10.640,P=0.005),进一步分析发现与HC组的CM和IM相比,RA组CM占比降低、IM比例增加,差异均有统计学意义(P=0.003,P=0.003)。RA组、HC组、疾病对照组单核细胞胞内TNF-α水平均呈IM最高,NCM次之,CM最低的趋势。RA患者IM胞内TNF-α水平和血清 TNF-α水平呈正相关(r=0.376,P=0.041)。RA组和疾病对照组的IM亚群表达HLA-DR水平均高于HC组[8 611.5(6 201.3,9 890.8),10 295.0(7 899.0,13 632.0),6 278.0(4 057.8,9 522.0),H=10.495,P=0.005]。RA患者外周血IM比例与临床指标CRP(r=0.119,P=0.359)、RF(r=0.204,P=0.112)、ESR(r=0.153,P=0.236)均无明显相关性,Logistic回归分析显示IM比例(OR=1.169,95
Objective This work aims to assess the distribution of peripheral blood monocyte subsets,the expression level of the functional markers in rheumatoid arthritis(RA)patients,and analyze the correlation between the above indexes and the onset of RA.Methods Peripheral blood mononuclear cells were collected and isolated from 62 RA patients,52 healthy control(HC)and 12 disease control group′s patients via density centrifugation.The enrolled patients were attended or underwent physical examination in East Hospital,Tongji University from June 2020 to December 2021.Monocytes could be classified into classical(CM),intermediate(IM)and non-classical(NCM).Then,the flow cytometry was performed to examine the distribution of monocyte subsets and the measure the expression level of human leukocyte antigen DR(HLA-DR),intracellular tumor necrosis factorα(TNF-α)in peripheral blood monocytes.The statistical methods in this study mainly include:Kruskal-Wallis H test,Chi-Square test,Mann-Whitney U test,Wilcoxon matched-pairs signed ranks test,Spearman correlation coefficient test and Logistic regression analysis.The diagnostic value of IM proportion in RA was analyzed by ROC curve.Results The monocytes number and monocytes proportion in white blood cells were much higher in RA[0.40(0.40,0.50),7.60%(5.97%,8.53%)]and disease control[0.40(0.40,0.68),8.20%(5.85%,10.28%)]compared with HC[0.30(0.30,0.40),5.80%(5.03%,6.38%)](H=24.733,P<0.001;H=27.469,P<0.001).A statistic-significant difference was detected among the proportion of CM[85.49%(76.91%,89.21%),88.94%(86.36%,91.72%),90.26%(80.25%,92.56%)],IM[11.65%(8.47%,17.89%),7.89%(5.36%,10.75%),5.56%(4.17%,8.27%)],NCM[2.22%(1.39%,3.74%),2.49%(1.74%,4.66%),5.13%(3.39%,9.85%)]in RA group,HC group and disease control group(H=11.389,P=0.003;H=20.815,P<0.001;H=10.640,P=0.005).The proportion of CM was lower in RA and the IM proportion was increased in RA(P=0.003;P=0.003).The intracellular TNF-αlevel of monocytes in all three groups revealed the trend that IM>NCM>CM.The intracellular TNF-αin IM
作者
袁佳仪
王岚
徐学静
徐臻
宗明
虞珊珊
陆英
谭琪
范列英
Yuan Jiayi;Wang Lan;Xu Xuejing;Xu Zhen;Zong Ming;Yu Shanshan;Lu Ying;Tan Qi;Fan Lieying(Department of Clinical Laboratory,Shanghai East Hospital,Tongji University School of Medicine,Shanghai 200120,China)
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2022年第9期906-913,共8页
Chinese Journal of Laboratory Medicine
基金
国家自然科学基金(81971535)。
