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目的:观察类风湿关节炎(RA)患者蛋白质的变化及其相关性分析。方法:测定40例RA患者和20例正常对照组的PA、ALB、A/G、Apo-A1、Apo-B、HDL、LDL、Treg表达水平等,比较蛋白质各指标与Treg表达水平两者之间是否存在差异;分析蛋白质变化与生活质量、临床症状、活动性指标、焦虑自评量表(SAS)、抑郁自评量表(SDS)标准分、类风湿性关节炎活动度评分表(DAS-28)及调节T细胞等的相关性。结果:①活动期RA患者的PA、A/G、Treg水平较正常对照显著下降(P<0.01),40例RA患者PA下降的有37人,占92.5%;A/G下降的有21人,占47.5%。②TP、ALB与生理功能呈明显负相关(P<0.01或P<0.05);PA、ALB、A/G、HDL与DAS-28呈明显负相关(P<0.01或P<0.05);TP与心理功能、生活质量总计分呈明显负相关(P<0.05);GLO与DAS-28呈明显正相关(P<0.05);蛋白质指标与Treg水平无特殊相关性。③TP、ALB与步行时间呈明显负相关(P<0.01或P<0.05);④PA、ALB、TP、Apo-B与RBC、HB、Fe呈明显正相关(P<0.01或P<0.05);PA、ALB、A/G、HDL、Apo-A1与a1-AGP、CRP、ESR呈明显负相关(P<0.01或P<0.05);GLO与IgG、C3、ESR呈明显正相关(P<0.01或P<0.05);LDL与C4呈明显正相关(P<0.01);Apo-A1/B与PLT、IgM呈明显负相关(P<0.05)。结论:RA患者中存在蛋白质代谢的异常,具体表现为PA、A/G等指标水平明显下降,其变化与RA炎症活动有关,但与CD4+CD2+5CD1-27Treg表达水平关系有待进一步研究。
Objective: To observe the changes of protein in patients with rheumatoid arthritis (RA) and their correlation analysis. Methods: The expressions of PA, ALB, A / G, Apo-A1, Apo-B, HDL, LDL and Treg in 40 patients with RA and 20 normal controls were measured. (SAS), Depression Scale (SDS), Rheumatoid Arthritis Activity Scale (DAS) were used to analyze the relationship between protein expression and life quality, clinical symptom, activity index, SAS -28) and regulatory T cells and other related. Results: ① The levels of PA, A / G and Treg in active RA patients decreased significantly (P <0.01), while those in 40 RA patients decreased by PA (92.5%) and decreased in A / G patients , Accounting for 47.5%. There was a significant negative correlation between TP, ALB and physiological function (P <0.01 or P <0.05); PA, ALB, A / G and HDL were negatively correlated with DAS- Function and total quality of life (P <0.05). There was a significant positive correlation between GLO and DAS-28 (P <0.05). There was no significant correlation between protein and Treg levels. (3) There was a significant negative correlation between TP, ALB and walking time (P <0.01 or P <0.05); ④ PA, ALB, TP and Apo-B were positively correlated with RBC, HB and Fe (P <0.01 or P <0.05). There was a significant positive correlation between GLO and IgG, C3 and ESR (P <0.01 or P <0.01 or P <0.01) P <0.05). There was a significant positive correlation between LDL and C4 (P <0.01). Apo-A1 / B was negatively correlated with PLT and IgM (P <0.05). CONCLUSIONS: There are abnormalities of protein metabolism in RA patients. The indicators of PA, A / G and so on are obviously decreased. The changes are related to the inflammatory activity of RA, but the relationship with the expression of CD4 + CD2 + 5CD1-27Treg needs further study.