常用免疫抑制剂治疗对系统性红斑狼疮患者淋巴细胞亚群的影响  

Changes of lymphocyte subsets in systemic lupus erythematosus patients after common immunosuppressant therapy

作　　者：苏利沙[1] 张根豪[1] 邓少丽[2] 张俊华[1] 刘红春[1] 

机构地区：[1]郑州大学第一附属医院检验科,郑州450052 [2]第三军医大学大坪医院检验科,重庆400042

出　　处：《郑州大学学报（医学版）》2014年第2期236-239,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金81101199;河南省教育厅自然科学基金资助项目12A320035

摘　　要：目的:探讨常用免疫抑制剂(糖皮质激素联合环磷酰胺或吗替麦考酚酯)治疗对系统性红斑狼疮(SLE)患者外周血淋巴细胞亚群影响情况。方法:利用流式细胞仪检测83例SLE患者(24例未治疗患者和59例经免疫抑制剂治疗患者)及30名健康对照者外周血T细胞、B细胞和NK细胞比例。结果:与对照组比较,SLE组患者CD3+CD8+Ts细胞增加(t=5.552,P<0.001),CD3+CD4+Th细胞减少(t=8.061,P<0.001),Th/Ts比值降低(Z=6.880,P<0.001),CD3-CD16+CD56+NK细胞减少(Z=3.637,P<0.001),CD3-CD19+B细胞增加(Z=2.500,P=0.012)。同未治疗组相比,治疗组患者CD3+T细胞有增加趋势,但差异无统计学意义(t=1.802,P=0.075),CD3+CD4+Th细胞升高(t=2.581,P=0.012),Th/Ts比值升高(Z=2.205,P=0.027),CD3-CD19+B细胞降低(Z=2.151,P=0.031)。结论:淋巴细胞亚群比例失调在SLE患者中普遍存在,可能参与了SLE的发病机制;联合应用糖皮质激素和环磷酰胺或吗替麦考酚酯可有效调节Th/Ts比例,选择性抑制B细胞,使SLE患者外周血淋巴细胞各亚群比例趋于平衡。Aim： To investigate the changes of peripheral blood lymphocyte subsets in systemic lupus erythemaosus （ SLE） patients with therapy of common immunosuppressant （ prednisolone and CTX or MMF ） .Methods：The lymphocyte subsets of 83 patients with SLE （24 without therapy and 59 with therapy） and 30 healthy controls were chosen and the pro-portion of T cells , B cells and NK cells in peripheral blood was measured with flow cytometry .Results：The percentage of CD3 ＋CD4 ＋Th cells（t=8.061,P〈0.001）, CD3 -CD16 ＋CD56 ＋NK cells（Z=3.637,P〈0.001） and the Th/Ts ratio （Z=6.880,P〈0.001） were significantly lower in SLE patients than those in controls , while CD3 ＋CD8 ＋Ts cells（t=5.552,P〈0.001） and CD3 -CD19 ＋B cells（Z=2.500,P=0.012） were higher than those in controls.Compared with those without therapy, CD3 ＋T cells in patients with therapy increased, but the change was not obvious （t=1.802,P=0.075）.In comparison, the CD3 ＋CD4 ＋Th cells increased significantly（t=2.581,P=0.012）, so did the Th/Ts ratio （Z=2.205,P=0.027）.CD3 -CD19 ＋B cells in those with therapy were obviously fewer than those without therapy （Z=2.151,P=0.031）.Conclusion：The imbalance of lymphocyte subsets is common in SLE patients , which could involve in the pathogenesis of SLE .Compared with those without therapy , the combined therapy of prednisolone and CTX or MMF could regulate the Th/Ts ratio effectively and suppress B cells selectively , by which they contribute to the balance of lym-phocyte subsets in SLE patients .

关 键 词：系统性红斑狼疮 淋巴细胞亚群 免疫抑制剂 

分 类 号：R446.63[医药卫生—诊断学]