摘要目的: 观察类风湿关节炎(rheumatoid arthritis,RA)患者血清Ⅱ型胶原C端肽(type Ⅱ collagen C-terminal peptide,CTX-Ⅱ)、组蛋白去乙酰化酶3(histone deacetylase 3,HDAC3)水平变化,分析其与免疫功能、疾病活动度的关系。方法: 选取本院收治的84例RA患者(RA组)和84例体检健康者(NC组)。分析血清CTX-Ⅱ、HDAC3(酶联免疫吸附法)及免疫功能指标[免疫球蛋白(immunoglobulin,Ig)A、IgG、IgM、CD3+、CD4+、CD8+T细胞比例]、疾病活动度相关指标[C反应蛋白(C-reactive protein,CRP)、血沉(erythrocyte sedimentation rate,ESR)]水平变化情况。Pearson法分析血清CTX-Ⅱ、HDAC3分别与免疫指标、疾病活动度相关指标的相关性。结果: RA组CTX-Ⅱ(9.26±1.84 vs 4.59±0.62)、HDAC3(83.72±13.51 vs 20.15±4.90)水平高于NC组(t=22.044、40.542,P<0.05)。缓解组CTX-Ⅱ(7.37±1.71 vs 10.75±1.94)、HDAC3(72.97±12.10 vs 92.18±14.62)水平低于活动组(t=8.347、7.940,P<0.05)。RA组CD3+(64.42±6.91 vs 70.42±7.34)、CD4+(34.80±5.96 vs 39.74±5.80)T细胞比例低于NC组,而CD8+T细胞(31.68±6.15 vs 29.62±7.15)、IgM(2.06±0.39 vs 1.47±0.30)、IgA(2.96±0.50 vs 1.51±0.36)、IgG(15.49±3.05 vs 11.83±2.19)、ESR(28.32±7.60 vs 13.75±2.18)、CRP(10.94±2.02 vs 6.08±0.73)水平显著高于NC组(P<0.05)。活动组患者CD3+(62.94±6.60 vs 66.30±7.30)、CD4+T(33.57±5.74 vs 36.36±6.24)细胞低于缓解组,IgM(2.19±0.41 vs 1.89±0.36)、IgA(3.08±0.54 vs 2.81±0.45)、IgG(16.16±3.27 vs 14.64±2.77)、ESR(30.06±8.15 vs 26.11±6.90)、CRP(12.37±2.24 vs 9.12±1.74)水平高于缓解组(P<0.05)。相关性分析显示,血清CTX-Ⅱ与ESR、CRP、28个关节疾病活动(disease activity score in 28 joints,DAS28)呈正相关(r=0.572、0.495、0.809,P均=0.000);血清HDAC3分别与CD3+、CD4+T细胞比例存在负相关(r=-0.529、-0.464,P均=0.000),而与IgM、IgA、IgG、ESR、CRP、DAS28评分呈正相关(r=0.460、0.491、0.445、0.540、0.519、0.864,P均<0.05)。结论: 类风湿关节炎患者血清CTX-Ⅱ、HDAC3水平均高于体检健康者,CTX-Ⅱ与RA疾病活动度有关,HDAC3与RA免疫功能紊乱以及疾病活动度有关。
Abstract：Objective: To observe the changes in serum type Ⅱ collagen C-terminal peptide (CTX-Ⅱ) and histone deacetylase 3 (HDAC3) levels in patients with rheumatoid arthritis (RA),and to analyze their relationship with immune function and disease activity. Methods: A total of 84 RA patients (RA group) and 84 healthy people (NC group) admitted to our hospital were gathered.The changes in serum CTX-Ⅱ,HDAC3,immune function indexes [proportion of immunoglobulin (Ig) A,IgG,IgM,CD3+,CD4+,CD8+ T cells] and disease activity related indexes [C-reactive protein (CRP),erythrocyte sedimentation rate (ESR)] were analyzed.Pearson method was applied to analyze the correlation of serum CTX-Ⅱ and HDAC3 with immune indexes and disease activity-related indexes,respectively. Results: The levels of CTX-Ⅱ(9.26±1.84 vs 4.59±0.62) and HDAC3(83.72±13.51 vs 20.15±4.90) in the RA group were higher than those in the NC group (t=22.044,40.542,P<0.05).The levels of CTX-Ⅱ(7.37±1.71 vs 10.75±1.94) and HDAC3(72.97±12.10 vs 92.18±14.62) in the remission group were lower than those in the active group (t=8.347,7.940,P<0.05).The proportion of CD3+(64.42±6.91 vs 70.42±7.34) and CD4+(34.80±5.96 vs 39.74±5.80) T cells in the RA group was lower than that in the NC group,while the levels of CD8+(31.68±6.15 vs 29.62±7.15) T cells,IgM(2.06±0.39 vs 1.47±0.30),IgA(2.96±0.50 vs 1.51±0.36),IgG(15.49±3.05 vs 11.83±2.19),ESR(28.32±7.60 vs 13.75±2.18),CRP(10.94±2.02 vs 6.08±0.73) were obviously higher than those in the NC group (P<0.05).The CD3+(62.94±6.60 vs 66.30±7.30) and CD4+(33.57±5.74 vs 36.36±6.24) T cells in the active group were lower than those in the remission group,and the levels of IgM(2.19±0.41 vs 1.89±0.36),IgA(3.08±0.54 vs 2.81±0.45),IgG(16.16±3.27 vs 14.64±2.77),ESR(30.06±8.15 vs 26.11±6.90),CRP(12.37±2.24 vs 9.12±1.74) were higher than those in the remission group (P<0.05).Correlation analysis showed that serum CTX-Ⅱ was positively correlated with ESR,CRP and disease activity score in 28 joints (DAS28) (r=0.572,0.495,0.809,all P=0.000); serum HDAC3 was negatively correlated with the proportions of CD3+ and CD4+ T cells,respectively (r=-0.529,-0.464,P=0.000),and was positively correlated with IgM,IgA,IgG,ESR,CRP and DAS28 (r=0.460,0.491,0.445,0.540,0.519,0.864,all P<0.05). Conclusion: Serum levels of CTX-Ⅱ and HDAC3 are elevated in RA patients compared to healthy individuals.CTX-Ⅱ is associated with disease activity in RA,while HDAC3 is related to immune dysfunction and disease activity.
2023, Vol. 29 
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