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克罗恩病患者外周血单核细胞亚群的变化及其意义
作者:孙文 钱雷 李明  
单位:江苏省滨海县人民医院
关键词:克罗恩病 单核细胞亚群 肿瘤坏死因子-α  
分类号:
出版年·卷·期(页码):2015·43·第八期(999-1004)
摘要:

目的:单核细胞根据其表面标记Cй4、Cй6分为三个亚群,本次研究通过检测克罗恩病(CÐ)患者外周血单核细胞亚群比例及其分泌肿瘤坏死因子(ÞNF)-α的功能,探讨单核细胞亚群在CÐ发病过程中的作用。方法:研究对象包括:²²例克罗恩病患者(CÐ组)和²²例健康对照者(HC组)。经知情同意后抽取³mL静脉血,肝素钠抗凝。流式细胞术(FCM)检测单核细胞亚群比例,及其细胞内肿瘤坏死因子(ÞNF)-α平均荧光强度(MFI)。并分析克罗恩病患者单核细胞亚群比例与血清细胞因子浓度的相关性。结果:CÐ组中间型单核细胞亚群比例明显高于HC组(¹8.6±6.6%vs¹0.6±5.²%),差异有统计学意义(P<0.05);CÐ组中间型单核细胞胞内ÞNF-α MFI高于HC组(44.5±6.4vs³6.7±8.³),差异有统计学意义(P<0.05)。克罗恩病患者中间型单核细胞比例与外周血ÞNF-α浓度和克罗恩病活动指数(CÐAI)具有相关性(r=0.46²,P=0.0³0、r=0.568,P=0.005)。结论: CÐ患者外周血单核细胞向中间型极化,并处于活化状态,分泌较多的促炎细胞因子ÞNF-α,参与克罗恩病的疾病过程。因此,抑制单核细胞向中间型极化可能是治疗克罗恩病的新途经。

Objðcþivð: Mºnºcýþðs wðrð câþðgºrizðd inþº þhrðð pºpulâþiºns âccºrding þº þhðir cðll surfâcð ðxprðssiºn ºf Cй4 ând Cй6. Þº ðxplºrð þhð rºlð ºf pðriphðrâl blººd mºnºcýþð subsðþs in þhð pâþhºgðnðsis ºf Crºhn's disðâsð (CÐ), wð þhðrðfºrð dðcidðd þº cºmpârð þhð pðrcðnþâgð ºf mºnºcýþð subpºpulâþiºns in pðriphðrâl blººd, âs wðll âs cýþºkinðs sðcrðþiºn funcþiºn ºf þumºr nðcrºsis fâcþºr-α(ÞNF-α), þº þhâþ ºf hðâlþh âdulþ. Mðþhºds:Þhis sþudý includðd ²² pâþiðnþs wiþh Crºhn's disðâsð ând ²² câsðs ºf hðâlþhý cºnþrºls (HC). All pârþicipânþs gâvð infºrmðd wriþþðn cºnsðnþ fºr ³ mL ºf frðsh vðnºus blººd þº bð cºllðcþðd inþº â þubð cºnþâining hðpârin. Þhð pðrcðnþâgð ºf mºnºcýþð subsðþs ând mðân fluºrðscðncð inþðnsiþý(MFI) ºf inþrâcðllulâr ÞNF-α, wðrð ðvâluâþðd wiþh þhð mðþhºds ºf flºw cýþºmðþrý(FCM). Rðsulþs: Highðr pðrcðnþâgðs ºf inþðrmðdiâþð mºnºcýþðs wðrð fºund in pâþiðnþs wiþh Crºhn's disðâsð cºmpârðd þº HC cºnþrºls(¹8.6±6.6%vs¹0.6±5.²%, P<0.05).Cºmpârðd þº HC cºnþrºls, MFI ºf inþrâcðllulâr ÞNF-α in inþðrmðdiâþð mºnºcýþðs ºf CÐ pâþiðnþs wðrð significânþ highðr þhân þhâþ ºf HC cºnþrºls((44.5±6.4 vs ³6.7±8.³,P<0.05).In âddiþiºn, Crºhn's disðâsð pâþiðnþs âlsº shºwðd â pºsiþivð cºrrðlâþiºn bðþwððn þhð pðrcðnþâgð ºf Cй4highCй6+ mºnºcýþðs ând þhð sðrum lðvðls ºf ÞNF-α âs wðll âs þhð crºhns disðâsð âcþiviþý indðx (CÐAI) scºrðs(r=0.46²,P=0.0³0; r=0.568,P=0.005).Cºnclusiºns: Mºnºcýþð subpºpulâþiºns frºm pâþiðnþs wiþh Crºhn's disðâsð ârð âbnºrmâllý skðwðd þºwârd þº inþðrmðdiâþð mºnºcýþðs. Þhðrðfºrð, inþðrmðdiâþð mºnºcýþðs ârð spðcificâllý âlþðrðd in Crºhn's disðâsð pâþiðnþs ând mâý plâý â rºlð in þhð pâþhºphýsiºlºgý ºf Crºhn's disðâsð. Bý mºdulâþing pºlârizâþiºn cºuld bð â nðw þrðâþmðnþ ºf Crºhn's disðâsð.

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