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华西医学  2012 

北川类风湿关节炎患者T细胞亚群分析

, PP. 1621-1624

Keywords: 类风湿关节炎,创伤后应激障碍,T细胞亚群

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Abstract:

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。

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