摘要
目的分析狼疮肾炎(LN)患者外周血淋巴细胞亚群的分布及差异,并探讨其临床意义。方法回顾性分析2020年1月至2022年12月就诊于安徽省立医院,诊断为系统性红斑狼疮(SLE)并行肾穿刺活检术经病理确诊为LN的106例患者临床、病理资料及相关实验室指标。流式细胞仪测定其外周血淋巴细胞亚群的比例,分析不同淋巴细胞亚群分布及其与临床指标的关系。结果106例LN患者中,CD3+T细胞比例为(75.58±10.04)%,其中CD4+T细胞比例降低有36例(33.96%),CD8+T细胞比例升高55例(51.89%),CD19+B细胞比例降低23例(21.70%),升高13例(12.26%),NK细胞比例降低45例(42.45%)。CD3+T细胞比例与活动性指数(AI)、系统性红斑狼疮活动指数(SLEDAI)、免疫球蛋白M(IgM)、抗C1q抗体均呈负相关(r=-0.250、-0.241、-0.207、-0.291;P<0.05),与补体C3呈正相关(r=0.238;P<0.05)。CD4+T细胞比例与尿β2微球蛋白呈负相关(r=-0.259;P<0.05),与免疫球蛋白A(IgA)呈正相关(r=0.193;P<0.05)。CD8+T细胞比例与免疫球蛋白G(IgG)、IgA、IgM、血沉(ESR)呈负相关(r=-0.216、-0.248、-0.279、-0.228;P<0.05)。CD19+B细胞比例与补体C3、C4呈负相关(r=-0.257、-0.214;P<0.05),而与SLEDAI、IgG、抗核小体抗体、抗C1q抗体、抗双链DNA(dsDNA)抗体呈正相关(r=0.200、0.204、0.241、0.271、0.264;P<0.05)。CD16+CD56+NK细胞与各临床表型之间无明显相关性(P>0.05)。结论LN患者的T、B淋巴细胞亚群比例与免疫球蛋白、补体、狼疮活动性指标、SLEDAI等存在相关性,对疾病预后有指导意义,测定T、B淋巴细胞亚群比例可能有助于判断LN的严重程度。
Objective To analyze the distribution and difference of peripheral blood lymphocyte subsets in patients with lupus nephri⁃tis(LN),and to explore the clinical significance.Methods There is a retrospective analysis was performed on the data of 106 patients who were diagnosed with systemic lupus erythematosus(SLE)and pathologically confirmed as LN by renal biopsy from January 2020 to December 2022 in Anhui Provincial Hospital.The data included clinical data,pathological data,and related laboratory indicators.The proportion of pe⁃ripheral blood lymphocyte subsets was measured by flow cytometry,and the distribution of different lymphocyte subsets and their relationship with clinical phenotype was analyzed.Results Among the 106 patients with LN,the proportion of CD3⁺T cells was(75.6±10.0)%,of which,the decrease in the proportion of CD4⁺T cells accounted for 36cases(34.0%),the increase in the proportion of CD8⁺T cells accounted for 55 cases(51.9%),the decrease in the proportion of CD19⁺B cells accounted for 23 cases(21.7%),and the increase of it accounted for 13 cases(12.3%),and the decrease in the proportion of NK cells accounted for 45 cases(42.5%).The proportion of CD3⁺T cells was negatively correlated with activity index(AI),systemic lupus erythematosus activity index(SLEDAI),immunoglobulin M(IgM)and anti-C1q antibody(r=-0.250,-0.241,-0.207,-0.291;P<0.05),while positively correlated with complement C3(r=0.238;P<0.05).The proportion of CD4⁺T cells was nega⁃tively correlated with urinaryβ2-microglobulin(r=-0.259;P<0.05)and positively correlated with IgA(r=0.193;P<0.05).The proportion of CD8⁺T cells was negatively correlated with IgG,IgA,IgM anderythrocyte sedimentation rate(ESR)(r=-0.216,-0.248,-0.279,-0.228;P<0.05).The proportion of CD19⁺B cells was negatively correlated with complement C3 and C4(r=-0.257,-0.214;P<0.05),while positively correlated with SLEDAI,IgG,anti-nucleosome antibody,anti-C1q antibody and anti-dsDNA antibody(r=0.200,0.204,0.241,0.271,0.264;P<0.05).There was no significant correlation between CD16⁺CD56⁺NK cells and clinical phenotypes(P>0.05).Conclusions The proportion of T and B lymphocyte subsetsin LN patients is correlated with the clinical indicators such as immunoglobulin,complement,lupus activity index and SLEDAI,which is meaningful for disease prognosis,and the determination of T and B lymphocyte subsets ratio may help to determine the sever⁃ity of LN.
作者
夏莹莹
蔡明龙
金慧芷
马艳
汪国生
厉小梅
陈竹
XIA Yingying;CAI Minglong;JIN Huizhi;MA Yan;WANG Guosheng;LI Xiaomei;CHEN Zhu(Department of Rheumatology and Immunology,Provincial Hospital Affiliated of Anhui Medical University,Hefei 230001,China;Department of Rheumatology and Immunology,the First Affiliated Hospital of University of Science and Technology of China,Heifei 230001,China)
出处
《安徽医学》
2024年第7期821-827,共7页
Anhui Medical Journal
作者简介
通信作者:陈竹,doczchen@ustc.edu.cn。
