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[类风湿关节炎患者免疫学研究的评估]

[Evaluation of immunological studies in patients with rheumatoid arthritis].

作者信息

Ostanek L

机构信息

Kliniki Hematologii Instytutu Chorób Wewnetrznych Pomorskiej Akademii Medycznej.

出版信息

Ann Acad Med Stetin. 1992;38:141-55.

PMID:1290348
Abstract

Immunological studies are widely applicable at a clinic in rheumatoid patients, despite the fact that their clinical value is still a disputable subject. Many authors are of opinion that the determination of individual immunological tests does not provide the estimation of immunological state in patients, and should be evaluated critically. The aim of the actual paper was to evaluate the immunological state of patients with rheumatoid arthritis by means of immunological profile index, which consists in performing concurrently many immunological tests involving both humoral immunology and cellular one. The results were referred to the duration of the disease, pathological process activity, the presence of rheumatoid factor, the advancement of osseous changes. The studies were carried out in patients, aged 16-69 years, 63 of them had RA and 9 were affected by ankylosing spondylitis. The control group comprised 16 normal subjects aged 28-61 years. It has been disclosed that the values of the immunological profile index in patients were statistically significantly lower than in the control group. The lowest values of immunological profile index were recorded in patients with extra-articular symptoms with recurrent infections of urinary and respiratory tracts, as well as in patients with active form of RA, and the presence of rheumatois factor. The patients with ankylosing spondylitis were found to reveal immunological disorders, but they were expressed less markedly than in RA patients. With the help of immunological profile it was possible to show that multifunctional immunological disorders appeared in patients with rheumatoid arthritis. The most sensitive immunological tests were: levels of immunoglobulins in blood serum, and the count of lymphocytes T and B. The immunological profile study in patients with rheumatoid inflammation of joints is an objective method of evaluating their immunological state.

摘要

免疫学研究在类风湿患者的临床中广泛应用,尽管其临床价值仍是一个有争议的话题。许多作者认为,单独的免疫学检测并不能评估患者的免疫状态,应对其进行批判性评估。本文的目的是通过免疫谱指数评估类风湿关节炎患者的免疫状态,该指数包括同时进行多项涉及体液免疫和细胞免疫的免疫学检测。研究结果与疾病持续时间、病理过程活动度、类风湿因子的存在情况以及骨质改变的进展情况相关。研究对象为16至69岁的患者,其中63例患有类风湿关节炎,9例患有强直性脊柱炎。对照组包括16名年龄在28至61岁的正常受试者。研究发现,患者的免疫谱指数值在统计学上显著低于对照组。免疫谱指数最低值出现在有泌尿系统和呼吸道反复感染的关节外症状患者以及类风湿关节炎活动期且存在类风湿因子的患者中。强直性脊柱炎患者也存在免疫紊乱,但不如类风湿关节炎患者明显。借助免疫谱可以表明类风湿关节炎患者出现了多功能免疫紊乱。最敏感的免疫学检测是:血清免疫球蛋白水平以及T淋巴细胞和B淋巴细胞计数。对关节类风湿炎症患者进行免疫谱研究是评估其免疫状态的一种客观方法。

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