Expression Of P-gp And Bcl-2 In Peripheral Blood Lymphocytes Of Patients With Refractory Rheumatoid Arthritis And Its Correlation With TCM Cold And Heat Syndrome

Objective:This study by detecting multi-resistant P-glycoprotein (permeability glycoprotein, P-gp), B-cell lymphoma/leukemia-2apoptosis gene (B-cell lymphoma/leukemia-2gene, Bcl-2) on rheumatoid arthritis (rheumatoid arthritis, RA) treated first, effective group and peripheral blood lymphocytes in patients with refractory group on expression level, and the results were compared with healthy people, analysis the clinical indexes of patients with RA groups of P-gp, the relevance of the Bcl-2expression level, to explore the expression of P-gp、Bcl-2and the possible mechanism of refractory RA multi-resistant formation and relevance to fever syndrome type of traditional Chinese medicine, has provided the new mentality for the further study of refractory RA and clinical trials.Method:In this paper, according to the inclusion criteria to collect healthy controls with early RA treated group, the effective group and15cases of refractory group. By flow cytometry direct labeling immunofluorescence method to detect healthy controls and patients with RA groups peripheral blood lymphocyte P-gp, the expression of Bcl-2fluorescence value; At the same time, a detailed record healthy control group and each group RA patients age、sex、disease course、clinical symptoms、signs、TCM syndrome integral value、coating on the tongue and pulse condition、ESR、CRP、RF、 DAS28score, such as clinical data, and compare the P-gp、Bcl-2and fever syndrome of TCM clinical indicators and symptoms and signs of correlation, using SPSS statistical software for statistical processing and analysis of P-gp%Bcl-2expression level and the correlation.Finally:1. Peripheral blood lymphocytes in patients with early RA treated group P-gp、Bcl-2expression were slightly higher than healthy control group, but no difference between statistical significance (P>0.05).2.Effective group of peripheral blood lymphocytes in patients with RA P-gp、Bcl-2expression were higher than healthy controls with early RA treated group, and between the difference was statistically significant (P<0.05on both sides).3. Peripheral blood lymphocytes in patients with RA refractory group P-gp、Bcl-2expression were significantly higher than that of healthy controls and early RA treated group, effective, and the difference between the two was statistically significant (P<0.05on both sides).4. RA patients with each of the ESR、CRP、RF and DAS28score and peripheral blood lymphocyte P-gp, no obvious correlation of the Bcl-2expression.5. Peripheral blood lymphocytes of patients with RA P-gp%cl-2expression are related and have a positive trend.6. Cold syndrome or hot syndrome with RA patients peripheral blood lymphocyte of P-gp、 Bcl-2expression differences had no statistical significance (P>0.05).7. Cold syndrome and heat syndrome patients with RA clinical indicators and symptoms and signs of comparative differences had no statistical significance (P>0.05); But cold syndrome RA patients compared with RF heat syndromes RA patients, between the difference was statistically significant (P<0.05on both sides).8. Cold syndrome and heat syndrome patients with RA morning stiffness and joint swelling degree no obvious correlation between P-gp and Bcl-2expression; But cold syndrome and heat syndrome RA patients degree of joint pain, joint tenderness and joint activity degree and P-gp、Bcl-2expression is high, moderate and have obvious positive correlation.Conclusion:1. Before treatment in patients with RA multi-resistant does not occur, but there may be a few patients primary resistance.2. DMARDs (such as methotrexate, fluorine milt) in the treatment of RA, can be induced by RA patients peripheral blood lymphocyte of P-gp、Bcl-2expression level increased, result in RA patients occurred in the process of multi-drug resistance.3. P-gp、Bcl-2patients participated in the RRA multi-resistant is one of the patients with RRA multi-resistant formation mechanism.4. Heat may be related to the formation of RA patients degree of RF high drop.5. RA patients with fever syndrome type of the degree of joint pain, joint tenderness degree and degree of joint activities and peripheral blood lymphocyte P-gp、Bcl-2high expression.