辅助性T细胞1/辅助性T细胞2失衡在系统性红斑狼疮患者治疗前后变化的研究  

Changes of Th1/Th2 imbalance in patients with systemic lupus erythematosus before and after treatment

作　　者：车国柱[1] 靳雪琴[1] 茹晋丽[1] 颉晓香[1] 孙慧萍[1] 高聪辉[1] 张露月[1] 李小峰[2] 

机构地区：[1]中国人民解放军第264医院风湿免疫科,太原030001 [2]山西医科大学第二医院风湿科

出　　处：《中国药物与临床》2015年第8期1071-1073,共3页Chinese Remedies & Clinics

基　　金：国家高技术研究发展计划(012AA02A513);山西省科技攻关项目(20120313025-7)

摘　　要：目的通过研究初发、复发系统性红斑狼疮(SLE)及初发SLE治疗前后外周血辅助性T细胞1(Th1)、辅助性T细胞2(Th2)细胞及Th1/Th2的变化,探讨Th1、Th2细胞及Th1/Th2的变化在SLE发病中的作用及治疗对其的影响。方法收集102例SLE患者(初发者53例,复发者49例)及30名健康对照,并对其中25例初发者在使用糖皮质激素联合环磷酰胺治疗4周临床缓解后随访观察。采用SLE疾病活动指数(SLEDAI)评分判断SLE的活动性,其中中高疾病活动组患者(SLEDAI>9分)60例,低疾病活动组患者(SLEDAI≤9分)42例。用四色分选流式细胞仪检测外周血Th17、调节性T细胞(Treg细胞)百分数。组间均值差异采用单因素方差分析、治疗前后的比较采用配对t检验。结果 1SLE初发者与复发者之间Th1、Th2细胞及Th1/Th2差异无统计学意义(P>0.05)。2SLE患者组与健康对照组Th1、Th2细胞及Th1/Th2差异无统计学意义(P>0.05);中高疾病活动组与低疾病活动组之间Th1细胞差异无统计学意义(P>0.05),Th2细胞较低疾病活动组显著降低(P=0.041),Th1/Th2较低疾病活动组显著升高(P=0.015);中高疾病活动组与健康对照组、低疾病活动组与健康对照组之间Th1、Th2细胞及Th1/Th2差异均无统计学意义(P>0.05)。3初发SLE患者组与中高疾病活动组治疗后Th1细胞降低、Th2细胞变化不明显,Th1/Th2减低,差异无统计学意义(P>0.05);低疾病活动组患者治疗后Th1细胞无明显变化,Th2细胞减低,Th1/Th2升高,差异均无统计学意义(P>0.05)。结论初发与复发SLE患者之间存在相同的Th1/Th2失衡机制,Th1/Th2失衡在不同疾病活动度患者中失衡方向不同,经治疗临床症状缓解后Th1/Th2趋于重新恢复平衡。Objective To investigate the effects of Thl and Th2 cells and Thl/Th2 changes in the pathogenesis and treatment of systemic lupus erythematosus （SLE） by determining the peripheral blood Thl and Th2 cells and Thl/ Th2 changes of incipient and relapsed SLE, before and after the treatment. Methods A total of 102 SLE cases （53 with incipient SLE and 49 with relapsed SLE） and 30 healthy controls were included in the study. Twenty-five with incipient SLE received glucocorticoid and cyclophosphamide for 4-week, and were followed up after the treatment with relieved clinical symptoms. The SLE disease activity index （SLEDAI） score was used to verify SLE activity. There were 60 cases in the middle and high-disease activity group （SLEDAI〉9） and 42 cases in the low disease activity group （SLEDAI ≤9）. Four-color separating flow cytometer （FCM） was used to test the percentage of peripheral blood Thl7 and Treg cells. One-way analysis of variance （ANOVA） was used to compare the mean difference between the two groups. Paired T test was used to compare the mean difference between the two groups before and after the treatment. Result （1）There were no statistically significant differences in Thl and Th2 cells, and Thl/Th2 between SLE incipient and relapsed patients （P〉0.05）. （2）There were no statistically significant differences in Thl and Th2 cells and Thl/Th2 between the SLE group and the healthy control group （P〉0.05）. No statistically significant difference was found in Thl cells between the middle- and high-disease activity group and low disease activity group （P〉0.05）. Com- pared with the low disease activity group, the Th2 cells were significantly decreased （P=0.041） and the Thl/Th2 cells were significantly increased （P=0.015） in the middle- and high-disease activity group. There were no statistically significant differences in Thl and Th2 cells and Thl/Th2 between the middle- and high-disease activity group or low disease activity group and the healthy control

关 键 词：红斑狼疮 系统性 T淋巴细胞 辅助诱导 流式细胞术 

分 类 号：R593.241[医药卫生—内科学]