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作者	单位	E-mail
叶雪英	广州中医药大学东莞医院风湿科广东东莞 523000	18629203562@163.com
黎学建	广州中医药大学东莞医院风湿科广东东莞 523000
彭剑虹	广州中医药大学东莞医院风湿科广东东莞 523000
尹晓霞	广州中医药大学东莞医院风湿科广东东莞 523000
张雪飞	广州中医药大学东莞医院骨科广东东莞 523000

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中文摘要:

摘要目的：探讨T淋巴细胞亚群、血红蛋白及血小板在类风湿关节炎患者中的表达及临床意义。方法：选取我院2020年1月到2023年1月收治的100例类风湿关节炎患者作为研究对象，依照患者病情活动性进行分组，将活动期类风湿关节炎的35例患者分为活动期组，将65例缓解期类风湿关节炎患者分为缓解期组，另选取同期体检的50名健康志愿者作为对照组，对比三组患者CD3⁺、CD4⁺、CD8⁺以及CD4⁺/CD8⁺比值，并对比三组受检者血红蛋白及血小板表达水平。应用Spearman相关分析分析T淋巴细胞亚群、血红蛋白及血小板与类风湿关节炎活动程度的相关性，并应用logistic回归分析分析T淋巴细胞亚群、血红蛋白及血小板对类风湿关节炎活动期的独立预测价值。结果：三组受检者T淋巴细胞亚群表达水平对比有差异，且活动期组CD3⁺、CD4⁺、CD4⁺/CD8⁺水平较缓解期组和对照组低，CD8⁺水平较高（P＜0.05）；三组受检者血红蛋白及血小板表达水平对比差异显著，且活动期组血红蛋白水平较缓解期组和对照组低，血小板水平较高（P＜0.05）；Spearman相关分析结果显示：CD3⁺、CD4⁺、CD4⁺/CD8⁺、血红蛋白与类风湿关节炎病情活动程度呈负相关，CD8⁺、血小板与类风湿关节炎病情活动程度呈正相关（P＜0.05）；logistic回归分析结果表明：CD4⁺/CD8⁺升高、血红蛋白升高及血小板降低为类风湿关节炎活动期的独立影响因素（P＜0.05）。结论：类风湿关节炎患者在疾病活动期T淋巴细胞亚群相关细胞比例、血红蛋白及血小板表达水平会出现明显变化，且与其活动程度具有明显相关性。以CD4⁺/CD8⁺升高、血红蛋白升高及血小板降低情况可独立判定类风湿关节炎活动期，因此临床上对于上述指标升高的类风湿关节炎患者需及时改善治疗措施，改善患者预后水平。

英文摘要:

ABSTRACT Objective: To investigate the expression and clinical significance of T lymphocyte subpopulations, hemoglobin, and platelets in patients with rheumatoid arthritis. Methods: 100 patients with rheumatoid arthritis admitted to our hospital from January 2020 to January 2023 were selected as the research subjects. They were grouped according to the activity of the patients' condition. 35 patients with active rheumatoid arthritis were divided into the active phase group, 65 patients with remission rheumatoid arthritis were divided into the remission phase group, and 50 healthy volunteers who came to our hospital for physical examination during the same period were selected as the control group. Three groups of patients were compared for CD3⁺, CD4⁺, CD8⁺ and CD4⁺/CD8⁺ ratios were compared, and the expression levels of hemoglobin and platelets were compared among the three groups of subjects. Spearman correlation analysis was used to analyze the correlation between T lymphocyte subpopulations, hemoglobin, and platelets and the degree of rheumatoid arthritis activity, and logistic regression analysis was used to analyze the independent predictive value of T lymphocyte subpopulations, hemoglobin, and platelets for the active stage of rheumatoid arthritis. Results: The expression level of T lymphocyte subsets among the three groups was different, and the level of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ level in the active group was lower and the CD8+ level was higher (P<0.05); the difference of hemoglobin and platelet expression level in the three groups was significant, and the hemoglobin level in the active group was lower than the remission group and the control group, and the platelet level was higher (P<0.05); The Spearman correlation analysis results showed that CD3⁺, CD4⁺, CD4⁺/CD8⁺, hemoglobin were negatively correlated with the degree of activity of rheumatoid arthritis, while CD8⁺, platelets were positively correlated with the degree of activity of rheumatoid arthritis(P<0.05); The results of logistic regression analysis showed that elevated CD4⁺/CD8⁺, elevated hemoglobin, and decreased platelet count were independent influencing factors for the active phase of rheumatoid arthritis(P<0.05). Conclusion: Patients with rheumatoid arthritis will experience significant changes in the proportion of T lymphocyte subpopulations related cells, hemoglobin and platelet expression levels during the active phase of the disease, and there is a significant correlation with their degree of activity. The active phase of rheumatoid arthritis can be independently determined by the increase of CD4⁺/CD8⁺, hemoglobin, and platelet count. Therefore, in clinical practice, timely improvement of treatment measures is necessary for rheumatoid arthritis patients with elevated above indicators to improve their prognosis.

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