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目的观察人脐带间充质干细胞(hUC-MSCs)对类风湿性关节炎(RA)患者DAS28、HAQ评分及血清因子的影响。方法选取2014年1月—2016年3月在新疆医科大学第一附属医院风湿免疫科治疗的RA患者100例作为研究对象,根据治疗方法不同分为观察组(n=55)和对照组(n=45),对照组给予非类固醇抗炎药和抗风湿药,观察组在对照组治疗基础上给予hUC-MSCs治疗,对比2组类风湿因子、抗CCP抗体、CRP及B细胞和CD4~+Treg水平、DAS28评分、HAQ评分。结果治疗前,2组的类风湿因子、抗CCP及CRP比较差异无统计学意义(t=0.434、0.955、0.684,P>0.05);治疗后,观察组的类风湿因子、CRP较治疗前均有所降低(t=6.789、16.183,P<0.05),对照组类风湿因子降低(t=2.542,P<0.05),且观察组的类风湿因子和CRP较对照组降低更为明显(t=-2.918、-14.147,P<0.05)。治疗前,2组的B细胞和CD4~+Treg比较差异无统计学意义(t=-0.461、0.172,P>0.05);治疗后,观察组CD4~+Treg较治疗前升高,而B细胞降低(t=-10.875、7.174,P<0.05),且观察组改善优于对照组(t=9.751、-8.115,P<0.05)。治疗前,2组的DAS28和HAQ评分比较无明显差异(t=-0.097、-0.276,P>0.05);治疗后,对照组的DAS28和HAQ评分较治疗前无明显变化(t=1.182、1.747,P>0.05)。观察组的DAS28和HAQ评分较治疗前降低(t=10.417、-5.905),且优于对照组(t=-5.905、-5.650,P<0.05)。结论 hUCMSCs在RA治疗中有一定的效果,可改善患者病情,调整免疫耐受,值得进一步研究。
Objective To observe the effects of human umbilical cord mesenchymal stem cells (hUC-MSCs) on DAS28, HAQ scores and serum factors in patients with rheumatoid arthritis (RA). Methods From January 2014 to March 2016, 100 RA patients treated by the Department of Rheumatology and Immunology of the First Affiliated Hospital of Xinjiang Medical University were enrolled in this study. The patients were divided into observation group (n = 55) and control group (n = 45). The control group was given NSAIDs and antirheumatic drugs. The observation group was treated with hUC-MSCs on the basis of the control group. The rheumatoid factor, anti-CCP antibody, CRP and B cells and CD4 ~ + Treg level, DAS28 score, HAQ score. Results Before treatment, there was no significant difference in rheumatoid factor, anti-CCP and CRP between the two groups (t = 0.434,0.955,0.684, P> 0.05). After treatment, the rheumatoid factor and CRP in the observation group were significantly lower than those before treatment (T = 2.542, P <0.05), and the rheumatoid factor and CRP in the observation group decreased more significantly than those in the control group (t = 6.789,16.183, P < -2.918, -14.147, P <0.05). Before treatment, there was no significant difference in CD4 + Treg between the two groups (t = -0.461,0.172, P> 0.05). After treatment, the CD4 ~ + Treg in the observation group was higher than that before treatment, while the B cells (T = -10.875, 7.174, P <0.05), and the observation group improved better than the control group (t = 9.751, -8.115, P <0.05). Before treatment, there was no significant difference between the two groups in DAS28 and HAQ scores (t = -0.097, -0.276, P> 0.05). After treatment, the DAS28 and HAQ scores of the control group had no significant difference (t = 1.182,1.747 , P> 0.05). The scores of DAS28 and HAQ in the observation group were lower than those before treatment (t = 10.417, -5.905), and better than the control group (t = -5.905, -5.650, P <0.05). Conclusion hUCMSCs have certain effect in the treatment of RA, which can improve the patient’s condition and adjust the immune tolerance, which deserves further study.