中文摘要：

目的观察类风湿关节炎患者的心、肺功能变化及其与外周血BTLA和氧化应激指标变化的相关性,探讨心肺功能下降的机制。方法选取RA患者100例并抽取40例健康人作为正常对照。采用肺功能仪检测患者肺功能参数FVC、FEV1、MVV、PEF、MEF25、MEF50、MEF75。采用超声心动图检测2组心功能参数EF%、SV%、FS%、E、A、E/A。流式细胞术检测BTLA表达频率及活化水平,魏氏法测定ESR,全自动生化仪测定hs-CRP。酶联免疫吸附法检测外周血细胞因子（IL-17、TNF-α、IL-4、IL-35）及氧化应激指标（MDA、ROS、SOD、TAOC）。结果 1）与NC组相比,RA患者肺功能参数均有不同程度降低;心功能参数EF、E峰、E/A明显降低,A峰明显升高,SV无明显差异;外周血IL-17、TNF-α和炎性指标ESR、CRP值显著升高,BTLA、IL-4、IL-35值显著降低,ROS、MDA明显升高,SOD、TAOC明显降低。2）相关性分析显示心功能参数与CD24^＋细胞、CD19^＋CD24^＋细胞、TAOC负相关,与BTLA、CD19^＋Cell、ROS、MDA、SOD呈正相关;肺功能各参数均与ESR、Hs-CRP、DAS28呈负相关,与BTLA、CD19^＋CD24^＋、SOD、TAOC、IL-4、IL-35呈正相关,与CD24^＋BTLA＋、ROS、MDA、IL-17、TNF-α呈负相关。结论 RA患者存在心肺功能降低,并与机体BTLA表达减弱、抗氧化能力下降密切相关。

英文摘要：

This study performed to observe the changes of cardiopulmonary function in rheumatoid arthritis（RA）patients, and to analyze its correlation with B and T lymphocyte attenuator（BTLA） and oxidative stress related indicators, thus to explore the mechanism of cardiopulmonary function decline. Total of 100 RA patients were included in the study, and other 40 healthy people were selected as normal control（NC）. Cardiopulmonary function detection, clinical examination and investigations were performed and disease activity was assessed. Expression and activation frequency of BTLA, cytokines（IL-17, TNF-α, IL-4, and IL-35） and markers of oxidative stress（MDA, ROS,SOD, TAOC） were also detected. Compared with the NC group, we found the indexes of pulmonary function were significantly reduced in RA, and cardiac function indexes EF%, E, E/A were significantly reduced but index A increased in RA patients, while index SV was found no obvious difference. Meantime, IL-17, TNF-α and inflammatory index as ESR, CRP increased but BTLA, IL-4, IL-35 decreased, and markers of oxidative stress as ROS, MDA increased, while antioxidant capacity as SOD, TAOC decreased significantly in RA. Correlation analysis showed that cardiac function indexes were negatively correlated with CD24^＋cell, CD19^＋CD24^＋cell, and TAOC, but positively related with ROS;index SV was positively related with MDA and SOD, while index E was negatively related with BTLA, CD19^＋cell,ROS, MDA, and SOD. Pulmonary function indexes were negatively correlated with ESR, Hs-CRP, DAS28, CD19^＋CD24^＋, ROS, MDA, IL-17, and TNF-α, but positively related with BTLA, CD24^＋BTLA＋, SOD, TAOC, IL-4, and IL-35.All above results suggested that cardiopulmonary function of RA patients is impaired, which closely relate with the decreased BTLA expression and antioxidation.