Analysis Of Relationship Between Leptin,CD4+/CD8+ And TCM Syndrome Types Of Rheumatoid Arthritis

Objective:To explore the relationship between leptin,CD4+/CD8+ and rheumatoid arth ritis(RA)TCM syndrome type,and provide an objective reference for RA TCM syndrome differentiation.Methods:According to the RA classification criteria and scoring system proposed by EULAR/ACR in 2010,199 patients with RA were enrolled,and 45 normal persons were sel ected as normal control group.According to the"TCM syndrome differentiation standard of rheumatoid arthritis diagnosis and treatment plan of Traditional Chinese Medicine Clinical Path of 95 Major Diseases in 22 Majors" formulated by the State Administration of Trad itional Chinese Medicine in 2010","Traditional Chinese Medicine Diagnostics" and "Practic al Chinese Medicine Internal Medicine",RA patients are divided into two major syndromes,six specific syndromes.Excess syndrome contains rheumatism stagnation syndrome,cold dam pness syndrome,damp heat stagnation syndrome and phlegm and blood syndrome,deficiency syndrome contains liver and kidney deficiency syndrome and Qi and blood deficiency synd rome.The fasting serum of normal persons and RA patients were collected for leptin and CD4+/CD8+ detection and the results were recorded.The basic information and laboratory parameters such as erythrocyte sedimentation rate and C-reactive protein of RA patients were collected.The data were analyzed by statistical software SPSS20.0.Results(1)There were statistically significant differences in leptin level and CD4+/CD8+ in seru m between the RA patients and the normal persons(P<0.001).The leptin level and CD4+ /CD8+ in serum in the RA patients were higher than those in the normal persons.(2)Leptin level and CD4+/CD8+ in serum in excess syndrome were higher than those in deficiency syndrome,and the differences were statistically significant(P<0.001).(3)There were significant differences in serum leptin level between the RA six TCM syndromes(P<0.001).The serum leptin level in the phlegm and blood syndrome was higher than those in other syndromes,and the differences were statistically significant(P<0.05).(4)There were statistically significant differences in serum CD4+/CD8+ between the RA six TCM syndromes(P<0.001).The serum CD4+/CD8+ in damp heat stagnation syndrome was higher than those in other syndromes,and the differences were statistically significant(P <0.0 5).(5)There was a significant positive correlation between serum leptin and DAS28 scores in the RA patients(P<0.001).(6)There was a significant positive correlation between serum CD4+/CD8+ and DAS28 scores in RA patients(P<0.001).(7)There was a positive correlation between the leptin level and CD4+/CD8+ in serum in RA patients(P<0.05).Conclusions(1)Among the RA six TCM syndrome types,the serum leptin level of the phlegm and blood syndrome was the highest,suggesting that serum leptin level can be used as one of the reference indicators of RA phlegm and blood syndrome.The serum CD4+/CD8+ of damp heat stagnation syndrome was the highest among six syndromes,suggesting that the serum CD4+/CD8+ can be used as one of the reference indicators for RA damp heat stagnation synd rome.(2)Leptin level and CD4+/CD8+ in serum in excess syndrome were higher than those in deficiency syndrome,suggesting that leptin level and CD4+/CD8+ in serum may be the basis of molecular biology and immunocytology of TCM excess pathogen.(3)There was a positive correlation between leptin level and CD4+/CD8+ in serum in RA patients,suggesting that there may be a certain relationship between leptin metabolism and ce llular immunity.