T Lymphocyte Subsets Analysis in Beichuan Patients with Rheumatoid Arthritis_West China Medical Journal

Authors：

ZOU Jin-mei, TIAN Lan, LI Si-yin. Department of Rheumatology, Central Hospital of Mianyang, Mianyang, Sichuang 621000, P. R. China;

Corresponding author：

Keywords：

类风湿关节炎; 创伤后应激障碍; T细胞亚群

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目的　探讨“5.12”地震后北川羌族人群中类风湿关节炎（RA）患者外周血 T细胞亚群的表达情况并分析创伤后应激障碍（PTSD）对RA患者细胞免疫之间的影响。方法　2009年3月－2010年3月，对98例北川羌族RA患者、112例健康对照，以及同期绵阳郊区84例RA患者、120例健康对照进行分析。用流式细胞仪分别检测CD3+、CD3+CD4+、CD3+ CD8+ T淋巴细胞数及CD4/+CD8+比值， RA疾病活动性采用DAS28测定，应用美国精神障碍诊断与统计手册第4版（DSM-Ⅳ）诊断标准调查RA人群中的PTSD患者，应用PTSD检查表平时版（PCL-C）检查对PTSD患者进行分析。结果　北川羌族与绵阳郊区RA活动组患者（分别为58例、39例）与健康对照组比较，CD8+ T淋巴细胞数降低，CD+4/CD8+比值增高，差异有统计学意义（P＜0.05）；北川羌族RA活动组与绵阳郊区RA活动组比较，CD3+ T淋巴细胞数降低，差异有统计学意义（P＜0.05）。北川RA患者中PTSD者（38例）与非PTSD者（60例）比较，PTSD组CD3+ T淋巴细胞数和CD4+/CD+8比值均明显低于PTSD组，差异有统计学意义（P＜0.05）；PCL-C对北川RA患者中PTSD的测定发现，PCL高分组CD3+ T淋巴细胞数显著低于PCL低分组（P＜0.05）。结论　 “5.12”地震后一部分RA患者出现T细胞免疫功能异常，且免疫功能异常与PTSD有关，对合并有PTSD的进行RA患者早期心理干预及药物治疗，改善患者生存质量。

Citation： DONG Jianling,YANG Jing,ZHANG Yu. T Lymphocyte Subsets Analysis in Beichuan Patients with Rheumatoid Arthritis. West China Medical Journal, 2012, 27(11): 1621-1624. doi: Copy

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1. 　Panayi GS, Lanchbury JS, Kingsley GH. The importance of the T cell in initiating and maintaining the chronic synovitis of rheumatoid arthritis [J]. Arthritis Rheu, 1992, 35(7): 729-735.
2. 　Häggqvist B, Hultman P. Effects of deviating the Th2-response in murine mercury-induced autoimmunity towards a Th1-response [J]. Clin Exp Immunol, 2003, 134(2): 202-209.
3. 　Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis [J]. Arthritis Rheum, 1988, 31(3): 315-324.
4. 　American Psychiatric Association.Diagnosis and statistic manual of mental disorders[M]. 4th ed. Washington DC：American Psychiatric Association, 1994: 424-429.
5. 　Van der Heijde DM, van’ t Hof MA, van Riel PL, et al. Validity of single variables and composite indices for measuring disease Activity in rheumatoid arthritis[J]. Ann Rheum Dis, 1992, 51(2): 177-181.
6. 　Hussein MR, Fathi NA, El-Din AM, et al. Alterations of the CD4(+), CD8 (+) T cell subsets, interleukins-1beta, IL-10, IL-17, tumor necrosis factor-alpha and soluble intercellular adhesion molecule-1 in rheumatoid arthritis and osteoarthritis: preliminary observations[J].Pathol Oncol Res, 2008, 14(3): 321-328.
7. 　李英楠, 赵育松, 李秀.类风湿性关节炎患者外周血T细胞亚群异常及调节的研究[J].中国中西医结合杂志, 2002, 22(5)：359-361.
8. 　Solomon GF, Segerstrom SC, Grohr P, et al. Shaking up immunity: psychological and immunologic changes after a natural disaster[J].Psychosom Med, 1997, 59(2): 114-127.
9. 　Hales RE, Zatzick DF.What is PTSD[J]. Am J Psychiatry, 1997, 154(2): 143-145.
10. 　王玲, 高艳红, 谷峰, 等.创伤后应激障碍对机体免疫和心肌酶类的影响[J].军医进修学院学报, 2010, 11: 1083-1084, 1146.
11. 　Lu PZ, Rodriguez-Llanes JM, Qi W, et al. Multiple injuries after earthquakes: a retrospective analysis on 1871 injured patients from the 2008 Wenchuan earthquake[J]. Crit Care, 2012, 16(3): R87.
12. 　邹晋梅, 杨静, 张羽, 等.汶川地震前后绵阳地区羌族人群风湿性疾病谱变化的调查分析[J] .西部医学, 2010, 22(8): 1558-1560.
13. 　Zhang Y, Ho SM.Risk factors of posttraumatic stress disorder among survivors after the 512 Wenchuan earthquake in China[J]. PLoS One, 2011, 6(7): 1-6.
14. 　Laudenslager ML, Aasal R. Elevated cytotoxicity in combat veterans with long-term post-traumatic stress disorder: preliminary observations[J]. Brain Behav Immun, 1998, 12(1): 74-79.
15. 　Wong CM. Post-traumatic stress disorder: advances in psychoneuroimmunology[J]. Psychiatr Clin North Am, 2002, 25(2): 369-383.

West China Medical Journal

T Lymphocyte Subsets Analysis in Beichuan Patients with Rheumatoid Arthritis

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