系统性红斑狼疮患者B淋巴细胞活化及CD154表达与狼疮抗凝物形成的关系  

Correlation between B lymphocyte activation and CD154 expression and the generation of lupus anticoagulants in patients with systemic lupus erythematosus

作　　者：赵秘胜 王晗 夏雯丽 朱小春[2] 朱丽青[3] 

机构地区：[1]温州市人民医院检验科,325000 [2]温州医科大学附属第一医院风湿免疫科,325000 [3]温州医科大学附属第一医院检验科,325000

出　　处：《中国医师进修杂志》2017年第5期418-421,共4页Chinese Journal of Postgraduates of Medicine

基　　金：浙江省自然科学基金资助项目（LQ15H200001）;温州市科技温州市科技局项目（2015Y0355）

摘　　要：目的探讨系统性红斑狼疮（SLE）患者B淋巴细胞活化及CD154表达与狼疮抗凝物（LAC）形成的关系。方法选取初诊SLE患者60例（SLE组）及健康志愿者32例（对照组），采集静脉血，流式细胞术检测外周血B淋巴细胞CD27和CD154表达情况，并计算阳性表达率；部分凝血活酶时间测定法检测LAC，当LAC比值〉1.20时判定为阳性。结果SLE组CD27阳性率、CD27表达强度、CD154阳性率和CD154表达强度均明显高于对照组（0.047 ± 0.021比0.035 ± 0.014、0.387 ± 0.185比0.214 ± 0.091、0.191 ± 0.108比0.101 ± 0.081和0.049 ± 0.018比0.022 ± 0.012），差异有统计学意义（P〈0.05或〈0.01）。SLE患者中，LAC阳性28例，LAC阴性32例。LAC阳性SLE患者CD27阳性率、CD27表达强度、CD154阳性率和CD154表达强度均明显高于LAC阴性SLE患者（0.055 ± 0.023比0.037 ± 0.014、0.444 ± 0.179比0.329 ± 0.123、0.218 ± 0.101比0.158 ± 0.044和0.058 ± 0.035比0.020 ± 0.009），差异有统计学意义（P〈0.05）。结论SLE患者LAC的产生与B淋巴细胞活化及其CD154的异常高表达有关，深入研究其发生机制，能为日后进行LAC产生的干预研究及降低SLE患者血栓发生风险提供理论依据。ObjectiveTo explore the correlation between B lymphocyte activation and CD154 expression and lupus anticoagulants （LAC） in patients with systemic lupus erythematosus （SLE）.MethodsSixty newly diagnosed SLE patients （SLE group） and 32 healthy controls （control group） were involved. The expressions of CD27 and CD154 in peripheral blood were determined by flow cytometry, and the positive expression rates were computed. The LAC was determined by activated partial thromboplastin time, and the LAC ratio 〉 1.20 was positive.ResultsThe positive rate of CD27, expression intensity of CD27, positive rate of CD154 and expression intensity of CD154 in SLE group were significantly higher than those in control group： 0.047 ± 0.021 vs. 0.035 ± 0.014, 0.387 ± 0.185 vs. 0.214 ± 0.091, 0.191 ± 0.108 vs. 0.101 ± 0.081 and 0.049 ± 0.018 vs. 0.022 ± 0.012, and there were statistical difference （P〈0.05 or 〈0.01）. Among patients with SLE, the LAC positive was in 28 cases, and the LAC negative was in 32 cases. The positive rate of CD27, expression intensity of CD27, positive rate of CD154 and expression intensity of CD154 in SLE patients with LAC positive were significantly higher than those in SLE patients with LAC negative： 0.055 ± 0.023 vs. 0.037 ± 0.014, 0.444 ± 0.179 vs. 0.329 ± 0.123, 0.218 ± 0.101 vs. 0.158 ± 0.044 and 0.058 ± 0.035 vs. 0.020 ± 0.009, and there were statistical differences （P〈0.05）.ConclusionsThe B lymphocyte activation and CD154 abnormal expression correlates with generation of LAC in patients with SLE. It provides a basis for the further study on intervening the generation of LAC and reducing the risk of thromboembolism.

关 键 词：红斑狼疮 系统性 B淋巴细胞 狼疮凝固抑制物 

分 类 号：R593.241[医药卫生—内科学]