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目的探讨强直性脊柱炎(Ankylosing spondylitis,AS)患者外周血辅助性T细胞(T helper lymphocyte,Th)与细胞毒性T细胞(T cytotoxic lymphocyte,Tc)亚群水平及临床意义。方法采用流式细胞术分析39例AS患者和26例健康者外周血Th17、Th1、Th2以及Tc1和Tc2比率,同时检测人类白细胞抗原B27(Human leucocyte antigen B27,HLA-B27)。结果 HLA-B27阳性AS组患者外周血Th17细胞比率[(1.93±0.70)%]显著高于健康对照组[(1.21±0.39)%](P<0.01)。Th细胞比率[(32.97±4.70)%]明显低于健康对照组[(36.64±4.08)%](P<0.01),Tc细胞比率[(34.05±5.21)%]显著高于对照组[(30.64±6.54)%](P<0.05),Tc2和Tc1细胞比率[(0.31±0.25)%、(33.74±5.16)%]均显著高于对照组[(0.20±0.11)%、(30.44±6.53)%](P<0.05),Th1细胞比率[(32.48±4.69)%]显著低于对照组[(36.30±4.13)%](P<0.01)。结论HLA-B27阳性AS患者Th17细胞比率增高,T细胞亚群极化失衡,呈明显的Th2/Tc2优势,可能与AS的疾病进程相关。
Objective To investigate the levels of T helper lymphocyte (Th) and cytotoxic T lymphocyte subsets in patients with ankylosing spondylitis (AS) and its clinical significance. Methods Th17, Th1, Th2, Tc1 and Tc2 ratios in 39 AS patients and 26 healthy controls were detected by flow cytometry. Human leukocyte antigen B27 (HLA-B27) was also detected. Results The percentage of Th17 cells in peripheral blood of HLA-B27-positive AS patients was significantly higher than that of healthy controls [(1.93 ± 0.70)% vs (1.93 ± 0.70)%, P <0.01). Th cell ratio [(32.97 ± 4.70)%] was significantly lower than that of the control group [(36.64 ± 4.08)%] (P <0.01) (0.31 ± 0.25)%, (33.74 ± 5.16)%] were significantly higher than that of the control group [(0.20 ± 0.11)%, (30.44 ± 6.53)%, P <0.05) %] (P <0.05), and the Th1 cell ratio [(32.48 ± 4.69)%] was significantly lower than that of the control group [(36.30 ± 4.13)%] (P <0.01). Conclusions The proportion of Th17 cells in HLA-B27-positive AS patients is increased, and the imbalance of T cell subsets shows a predominant Th2 / Tc2 advantage, which may be related to the progression of AS.