系统性红斑狼疮患者T细胞上Fas受体分子数与治疗效果的相关性  

The significance of quantitative measurement of Fas receptor molecules expression on T lymphocytes surface in the treatment of systemic lupus erythematosus

作　　者：李富荣 叶志中[2] 肖学吕 齐晖 任莉莉 张丽君[2] 王新根 

机构地区：[1]深圳市人民医院(暨南大学医学院第二附属医院)临床医学研究中心,518020 [2]广东医学院深圳市风湿病研究所 [3]深圳市人民医院(暨南大学医学院第二附属医院)风湿免疫科,518020

出　　处：《中华风湿病学杂志》2005年第9期541-543,共3页Chinese Journal of Rheumatology

基　　金：广东省自然科学基金资助项目(021339)

摘　　要：目的通过定量流式细胞术检测系统性红斑狼疮(SLE)患者T淋巴细胞表面Fas受体的分子数(Fas/T),探讨其对疾病治疗效果的指导作用。方法36例活动期SLE患者,分别给予泼尼松、甲泼尼龙、环磷酰胺冲击治疗,在入院3d内、出院时(平均住院天数为22.6d)和出院后4周复诊时,采集患者外周血,采用Fas定量流式细胞试剂盒荧光染色,通过流式细胞仪对T淋巴细胞上表达Fas受体分子数(Fas/T)进行检测。结果活动期SLE患者随着皮质类固醇或免疫抑制剂治疗,到出院时T细胞表面Fas/T呈明显升高;出院后4周复诊时T细胞表面Fas/T呈下降趋势;各组间差异均有统计学意义(P<0.05)。SLE患者治疗前后T细胞表面Fas/T与SLE疾病活动指数(SLEDAI)之间,具有明显的相关性(P<0.05),治疗前后T细胞表面Fas/T与抗dsDNA抗体、C3和C4之间无明显的相关性(P>0.05)。结论SLE患者T淋巴细胞表面Fas/T与SLE的活动性呈正相关,可作为一种评价SLE疾病活动性的指标,对临床治疗效果具有一定指导作用。由Fas介导的淋巴细胞凋亡是引起SLE免疫功能紊乱的主要原因,也是判断狼疮活动的重要指标。Objective To study the slgnltleance of quaatitatively measuring the number ot Fas receptor molecules expressed on T lymphocyte surface in the treatment of systemic lupus erythematosus （SLE）. Medthods Thirty-six patients with active SLE were kept under observation. They were treated with ictus therapy of prednisone, methylprednisolone pulse therapy or cyclophosphamide respectively according to their eonditions. Within 3 days after admission and immediately before discharge （average 22.6 d）, and 4 weeks after discharge, the peripheral blood of each patient were sampled, and the number of Fas receptor molecules expressed on T lymphocytes was determined with flow cytometry after stained with CELLQUANT Fas kit. Results After treating with cortico steroid or immuuosuppressant, expression of Fas receptor molecules on T lymphoeytes was signifieantly higher than before treatment （P〈0.05）. Four weeks after discharge, the expression of Fas receptor molecules on T lymphocytes was decreased （P〈0.05）, There was signifieaut difference in each group （P〈0.05）.Along with tile decrease in disease activity of active SLE patients, there was a positive correlation between SLEDA1 and Fas receptor molecules on T lymphocytes before and after treatment（P〈0.05）, while the later had no correlation with anti-dsDNA antibody and C3, C4 complements level （P〉0.05）. Conclusion The numher of Fas receptor molecules expressed on T lymphocytes from SLE patients exhibits a positive correlation with SLEDA1. Therefore, the number of Fas receptor on T cell is a fairly good indicator for evaluating the disease activity of SLE patients, and useful in guiding the clinical referral and management of SLE patients. The Fas-mediated apoptosis of lynlphocytes is the principal event that leads to the imnlune dysfunction of SLE.

关 键 词：系统性红斑狼疮 T细胞 FAS受体 受体分子数 淋巴细胞 细胞凋亡 

分 类 号：R593.241[医药卫生—内科学]