外周血单个核细胞早期凋亡与SLE患者器官/系统损害的关联研究  

Early apoptosis of peripheral blood mononuclear cells correlate with indices of damage of organ or system in systemic lupus erythematosus

作　　者：郝加虎[1] 张志华[2] 张国庆[2] 刘慧慧[2] 黄朝辉[1] 戴宏[3] 翟志敏[4] 叶冬青[2] 李庆[4] 张学军[5] 

机构地区：[1]安徽医科大学公共卫生学院,合肥230032 [2]安徽医科大学公共卫生学院流行病与卫生统计学系,合肥230032 [3]安徽医科大学第一附属医院肾脏内科,合肥230022 [4]安徽医科大学附属省立医院中心实验室,合肥230001 [5]安徽医科大学皮肤病研究所,合肥230022

出　　处：《中国卫生检验杂志》2008年第6期1025-1029,共5页Chinese Journal of Health Laboratory Technology

基　　金：国家自然科学基金资助(30371247);安徽省高校省级自然科学研究项目(KJ2007B148);安徽省高校青年教师科研资助计划(2004jq166;2007jq1067ZD);安徽医科大学博士科研经费资助计划(XJ200602)

摘　　要：目的:比较系统性红斑狼疮(systemic lupus erythematosus,SLE)患者和正常对照的外周血单个核细胞(peripheralblood mononuclear cells,PBMCs)早期凋亡率,分析PBMCs早期凋亡率与SLE患者疾病活动度的关系,并探讨PBMCs早期凋亡率对SLE患者器官/系统损害的影响。方法:以两所三甲医院住院SLE患者为病例组(n=76),以健康志愿者为对照组(n=69);参照系统性红斑狼疮疾病活动性指数(SLEDAI)和系统性红斑狼疮损伤指数(SLICC/ACR DI)量表,设计问卷,调查患者的一般情况、实验室检查结果和器官/系统损害情况;运用流式细胞术,采用连接素V(Annexin V,AV)和碘化丙啶(propidium iodide,PI)双染法检测研究对象的PBMCs早期凋亡率。结果:SLE患者的PBMCs早期凋亡率(13.29%±4.12%,n=76)高于正常对照组(4.66%±1.57%,n=69)(Z=9.657,P<0.01),活动期患者(SLEDAI 10)的早期凋亡率(14.80%±5.09%,n=53)高于非活动期(SLEDAI<10)(9.82%±3.76%,n=23),高于正常对照(4.66%±1.57%,n=69)(F=120.28,P<0.01)。PBMCs的早期凋亡率与SLEDAI(r=0.249,P=0.03),SLICC/ACR DI(rs=0.612,P<0.001)均呈正相关。具有肾脏损害或精神/神经系统损害的患者PBMCs早期凋亡率升高更为显著(P分别为0.001和0.039)。结论:SLE患者的PBMCs早期凋亡率显著升高,且与患者的疾病活动度和器官/系统损害程度相关,发生肾脏损害或精神/神经系统损害时PBMCs早期凋亡率增加尤为明显,PBMCs早期凋亡率能够较好地反映SLE患者器官/系统损害的严重程度。凋亡紊乱在SLE的发病和器官/系统损害中发挥重要作用。Objective：To compare the early apoptotic rate of peripheral blood mononuclear cells （PBMCs） between healthy controls and patients with systemic lupus erythematosus （SLE） to analyze the relationship between the early apoptotic rate of PBMCs and disease activity and study the influence of PBMCs apoptosis on the damage of organ or system ;.n SLE. Methods： SLE patients （ n = 76 ） were selected from two hospitals and normal healthy volunteers （ n = 69 ） were recruited as controls. General information, chemical examination results and data on the organ or system damage were collected by self - designed questionnaire containing the systemic lupus erythematosus disease activity index （SLEDAI） and the Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index （ SLICC/ACR DI）. The early apoptotic rate of PBMCs was detected by flow cytometry （FCM） using annexin V （AV） and propidium iodide （PI）. Results： Patients with SLE had a significantly higher early apoptotic rate of PBMCs （13.29% ± 4. 12%, n = 76 ） compared to healthy controls （4.66% ±1.57%,n=69） （Z=9.657, P〈0.01）, and SLE patients with active disease （ SLEDAI _〉 10） （ 14. 80%± 5. 09%,n =53） had a higher apoptotic rate compared to patients with inactive disease （SLEDAI 〈 10） （9. 82% ±3.76%, n =23）. Both groups had higher apoptotic rates than healthy controls （ F = 120. 28, P 〈 0. 01 ）. A significant positive correlation was found between the early apoptotic rate of PBMCs, SLEDAI （ r = 0. 249, P = 0. 03 ）, and SLICC/ACR DI （ rs= 0.612, P 〈 0. 001 ）. Elevated early apoptotic rate of PBMCs were associated with renal disease and neuropsychiatric involvement in SLE （ P = 0. 001 and 0. 039, respectively）. Conclusion：There is an increase of early apoptotic rate of PBMCs among SLE patients, and the early apoptotic rate of PBMCs has a positively correlation with disease activity. Patients with renal disease and neuropsychiatric involvement

关 键 词：红斑狼疮 系统性 细胞凋亡 外周血单个核细胞 

分 类 号：R593.241[医药卫生—内科学]