吗替麦考酚酯对老年系统性红斑狼疮患者免疫细胞水平变化的影响  

The effect of Mycophenolate Mofeti on the changes of immune cells in old patients with systemic lupus erythematosus

作　　者：李倩倩[1] 姜振宇[1] 赵令[1] 马宁[1] 王凯[1] 张彦东[1] 

机构地区：[1]吉林大学白求恩第一医院风湿免疫科,长春130021

出　　处：《中国免疫学杂志》2012年第12期1136-1138,共3页Chinese Journal of Immunology

基　　金：吉林省科技厅基金项目(201115051)

摘　　要：目的:探讨吗替麦考酚酯(MMF)对老年系统性红斑狼疮(SLE)的外周血T细胞、B细胞、自然杀伤(NK)细胞水平变化的影响。方法:选取30例老年SLE患者作为实验组,同时随机抽取30例健康老年作为对照组,流式细胞术检测其外周血T细胞、B细胞及NK细胞水平变化。将30例老年患者随机平分为2组:一组静点泼尼松治疗,另一组口服MMF联合泼尼松治疗。结果:与对照组比较,老年SLE患者CD3+CD4+Th细胞明显降低(P<0.000 1),CD3+CD8+Ts细胞(CD3+CD8+抑制性T细胞)明显升高(P=0.000 3);老年SLE患者CD3-(CD16CD56)+NK、CD3+(CD16CD56)+NK细胞较对照组明显降低(P<0.000 1),而CD3-CD19+B细胞较对照组明显增高(P=0.000 2)。老年SLE患者外周血CD3-CD19+B细胞与SLEDAI呈正相关性(P=0.003 4,R=0.267 8)。CD3+CD4+Th(P=0.071 0,R=0.315 0)、CD3+CD8+Ts(P=0.126,R=0.245 6)、NK(P=0.098 7,R=0.574 1)细胞与SLEDAI活动指数无明显相关性。单用激素组治疗后CD3-CD19+B细胞较治疗前明显降低(P=0.035 9)。MMF联合激素组,治疗后CD3+CD4+Th细胞较治疗前明显升高(P=0.002),CD3-CD19+B细胞较治疗前明显降低(P<0.000 1)。MMF联合激素组对淋巴细胞亚群的影响优于单用激素组。结论:免疫细胞亚群的改变在老年SLE发病中起重要作用。联合应用糖皮质激素和MMF优于单用激素。Objective：To investigate the effects of Mycophenolate Mofetil（MMF）on peripheral blood cells including T and B,natural killer（NK）cells in elderly patients with systemic lupus erythematosus（SLE）.Methods：30 cases of elderly SLE patients were selected as experimental group,at the same time 30 cases of healthy elders were randomly chosen as control group.The changes of T and B peripheral blood cells and NK cells were measured by flow cytometry.30 cases of patients were randomly divided into 2 groups：intravenous drip（IVD）with prednisone and oral MMF with prednisone.Results：Compared with control,the percentage of CD^3＋CD4＋Th cells was significant lower（P0.000 1）,while the percentage of CD^3＋CD^8＋Ts cells was higher（P=0.000 3）in the old SLE patients group.The CD3-（CD16CD56）＋NK and CD^3＋（CD16CD56）＋NKT cells were lower（P〈0.000 1）,while the CD3^-CD19^＋B cells were higher（P=0.000 2）in the old SLE patients group than those of the healthy control group.A significant positive correlation was obtained between the proportion of CD3^-CD19^＋B in old SLE patients and SLEDAI（P=0.003 4,R=0.267 8）.There were no relation between the percentages of CD^3＋CD4＋Th（P=0.071 0,R=0.315 0）,CD^3＋CD^8＋Ts（P=0.126,R=0.245 6）,NK（P=0.098 7,R=0.574 1）cells and SLEDAI.After treatment,the CD3^-CD19^＋B were dramatically lower in the GC group than before treatment.After treatment,CD^3＋CD4＋Th cells were higer（P=0.002） and CD3^-CD19^＋B cells were lower（P0.000 1）than before treatment in the MMF combined with GC group.The influence on lymphocyte subsets in the MMF combined with GC group was better than that of the GC group.Conclusion：The changes of immune cell subpopulations play an important role in elderly-onset SLE.In combination with glucocorticoid and MMF is better than using hormone alone.

关 键 词：系统性红斑狼疮 老年 淋巴细胞亚群 吗替麦考酚酯 

分 类 号：R392[医药卫生—免疫学]