Department of Rheumatology, The First Affiliated Hospital of Nanchang University, No. 17 Yongwaizheng Street, Donghu District, Nanchang City, Jiangxi Province, China.
BMC Musculoskelet Disord. 2024 Oct 21;25(1):829. doi: 10.1186/s12891-024-07935-8.
Rheumatoid arthritis (RA) is a prevalent autoimmune disorder that leads to chronic joint inflammation, deformity, disability, and systemic complications. This study aimed to analyze the clinical characteristics and synovial pathology of RA patients with synoviocyte detachment, and explore the factors associated with this phenomenon.
This was a retrospective cohort study included RA patients who underwent synovial biopsy at our center from April to September 2023. Demographic, clinical, laboratory, and synovial histological data were retrospectively collected from medical records at the time of joint synovial biopsy in patients. Microscopic examination of hematoxylin and eosin (HE)-stained synovial tissue sections categorized the samples into synoviocyte detachment and no-synoviocyte detachment groups. Clinical characteristics and synovial pathological changes were compared between the two groups, and the factors associated with synoviocyte detachment were explored through logistic regression analysis.
Fifty-five RA patients were enrolled; 45 were females, and the mean age was 53.4 ± 11.8 years. Nine RA patients exhibited synoviocyte detachment. A total of 46 RA patients in the no-synoviocyte detachment group (15 with a normal lining layer and 31 with synovial cell proliferation) were included. Compared with the no-synoviocyte detachment group, the synoviocyte detachment group presented higher RF, ESR, CRP and DAS28-CRP levels (P < 0.05). The synoviocyte detachment group exhibited more prominent neovascularization (P < 0.05). ESR, DAS28-CRP and synovial neovascularization were risk factors associated with synoviocyte detachment in RA patients.
RA patients with synoviocyte detachment exhibit elevated clinical disease activity, marked by pronounced synovial pathology featuring increased neovascularization and less inflammatory cell infiltration. A significant reduction in lymphocyte count compared with patients with synovial cell proliferation was also observed.
类风湿关节炎（RA）是一种常见的自身免疫性疾病，可导致慢性关节炎症、畸形、残疾和全身并发症。本研究旨在分析伴有滑膜细胞脱落的 RA 患者的临床特征和滑膜病理学表现，并探讨与该现象相关的因素。
这是一项回顾性队列研究，纳入了 2023 年 4 月至 9 月在我中心接受滑膜活检的 RA 患者。从患者关节滑膜活检时的病历中回顾性收集人口统计学、临床、实验室和滑膜组织学数据。苏木精和伊红（HE）染色的滑膜组织切片的显微镜检查将样本分为滑膜细胞脱落和无滑膜细胞脱落组。比较两组之间的临床特征和滑膜病理变化，并通过逻辑回归分析探讨与滑膜细胞脱落相关的因素。
共纳入 55 例 RA 患者，其中 45 例为女性，平均年龄为 53.4±11.8 岁。9 例 RA 患者出现滑膜细胞脱落。无滑膜细胞脱落组（15 例正常衬里层和 31 例滑膜细胞增生）共纳入 46 例 RA 患者。与无滑膜细胞脱落组相比，滑膜细胞脱落组的 RF、ESR、CRP 和 DAS28-CRP 水平更高（P<0.05）。滑膜细胞脱落组的新生血管化更为明显（P<0.05）。ESR、DAS28-CRP 和滑膜新生血管化是 RA 患者滑膜细胞脱落的相关危险因素。
伴有滑膜细胞脱落的 RA 患者表现出更高的临床疾病活动度，其滑膜病理学表现更为显著，包括新生血管化增加和炎症细胞浸润减少。与滑膜细胞增生的患者相比，淋巴细胞计数显著降低。
