淋巴细胞减少及抗淋巴细胞抗体在系统性红斑狼疮中的分布及意义  

Significance and distribution of lymphopenia and anti-lymphocyte antibody in systemic lupus erythematosus

作　　者：李春[1] 路晓燕[2] 李晶[1] 何菁[1] 叶华[1] 穆荣[1] 栗占国[1] 

机构地区：[1]北京大学人民医院风湿免疫科,100044 [2]北京大学深圳医院风湿免疫科

出　　处：《中华风湿病学杂志》2009年第5期316-319,I0002,共5页Chinese Journal of Rheumatology

基　　金：北京大学人民医院研究与发展基金（RDB2006-14）

摘　　要：目的了解淋巴细胞减少、抗淋巴细胞抗体（ALA）在系统性红斑狼疮（SEE）中的分布及意义，并探讨ALA在淋巴细胞减少中的作用。方法回顾性选取2003年2月至2008年2月住院的110例SLE患者作为研究对象。利用间接免疫荧光法测定上述患者的ALA。结果①淋巴细胞减少（〈1．5×10^9／L）的发生率为68．2％。淋巴细胞减少组与正常组在皮疹、浆膜炎、肾脏受累、神经系统异常、白细胞减少、抗核抗体（ANA）、抗双链DNA（dsDNA）抗体、红细胞沉降率（ESR）增快、IgG升高等方面的差异有统计学意义。淋巴细胞计数与SLE疾病活动指数（SLEDAI）评分的相关度好于白细胞计数。②ALA阳性率为46．4％，淋巴细胞减少组与健康组分别为61．3％与14．3％，两组差异具有统计学意义（P=0．000）。ALA阳性组与阴性组在狼疮肾炎（LN）、神经精神性狼疮、白细胞计数、C3降低、ANA、抗dsDNA抗体、SLEDAI评分等方面差异有统计学意义。结论淋巴细胞减少和疾病活动度显著相关。淋巴细胞减少和ALA相关，ALA可作为疾病活动的指标，并且和内脏损害及预后相关。Objective To investigate the significance and distribution of lymphopenia and antilymphocyte antibody（ALA） in systemic lupus erythematosus （SLE） and to explore the role of ALA in lymphopenia. Methods One hundred and ten in-patients who were admitted during February 2003 to February 2008 were retrospectively reviewed. Indirect immunofluorescence test was used to detect ALA. Results ① Lymphopenia （〈1.5×10^9/L） was observed in 68.2% patients. Lymphopenia was associated with skin rashes, serositis, renal involvement, NPSLE, leucopenia, ANA, ds-DNA antibody, ESR and IgG levels. The lymphocyte count and SLEDAI scores was more closely correlated than total white blood cell counts. ② ALA was positive in 51/120 （46.4%） patients. ALA was associated with renal involvement, NPSLE, WBC count, C3 level decrease, ANA, dsDNA antibody and SLEDAI scores. Conclusion Lymphopenia is significantly associated with SLEDAI scores. ALA is possibly one cause of lymphcytopenia. In addition, ALA is also a parameter for disease activity, and is associated with organ involvement and outcomes.

关 键 词：红斑狼疮 系统性 淋巴细胞减少 抗淋巴细胞血清 

分 类 号：R686[医药卫生—骨科学]