系统性红斑狼疮患者CD5＋ B细胞的变化及其意义  

Changes and significance of CD5＋ B lymphocyte in patients with systemic lupus erythematosus

作　　者：陈俊伟[1] 景晓娜[1] 郝美华[1] 梁赵云 杨金华[1] 吴萌[1] 介绍亮[2] 张升校 楚燕芳 赵春苗[1] 王静[1] 乔玥[1] 

机构地区：[1]山西医科大学第二医院风湿免疫科,太原030001 [2]山西省临汾市人民医院风湿免疫科

出　　处：《中华风湿病学杂志》2017年第8期513-517,I0001,共6页Chinese Journal of Rheumatology

基　　金：山西省科技攻关项目（20150313008-2）

摘　　要：目的测定SLE患者外周血淋巴细胞、B细胞、CD5＋ B细胞数量以及分泌的IL-10水平，并分析其在疾病中的作用。 方法本研究随机选取84例SLE患者组，根据其SLEDAI进行评价，将所入选患者分为低活动组（SLEDAI〈9分）和高活动组（SLEDAI≥9分），同时选取10名健康人为健康对照组。分别测定其淋巴细胞、B细胞、CD5＋ B细胞的数量、ESR、C3、C4以及血清中的IL-10水平，并分析上述指标与SLEDAI及补体的相关性。多组间比较采用方差分析，两两比较用LSD-t检验，以Spearman相关进行相关性分析。结果SLE组的淋巴细胞总数[（1.3±0.6）×10^9/L]低于健康对照组[（1.9±0.6）×10^9/L]（F=7.216，P〈0.01），SLE组的B细胞数[（295±10^3）个/μL]高于健康对照组[（200±80）个/μL]（F=3.589，P=0.036）；SLE患者外周血的CD5＋ B细胞[（2.5±0.6）%]与健康对照组[（3.2±0.8）%]相比明显下降，但差异无统计学意义（t=3.412，P=0.698）。高活动组CD5＋ B细胞数量明显低于低活动组（t=7.365，P=0.027）以及健康对照组（t=5.649，P=0.002）。CD5^＋ B细胞的数量与SLEDAI评分呈负相关（r=-0.692，P=0.001），与补体C3的水平呈正相关（r=0.305，P=0.038），但与补体C4和ESR无相关性（P〉0.05）。此外，无论低活动组还是高活动组的SLE患者血清中IL-10水平较健康对照组高（t=1.935，P=0.031和t=3.048，P=0.012）。SLE患者血清IL-10水平与SLEDAI评分呈正相关（r=0.425，P=0.024）与ESR呈正相关（r=0.479，P=0.008），而与C4呈负相（r=-0.359，P=0.031）。结论SLE患者淋巴细胞总数明显降低，而B细胞明显增多，并且随着疾病的活动度增加而进一步增加，CD5＋ B细胞数量以及IL-10的血清水平也发生了变化，可能与患者体内的炎性环境有关，并且其CD5＋B细胞的数量和IL-10血清水平可能与疾病的活动有关。ObjectiveTo measure the number of lymphocytes, B lymphocytes, CD5＋ B lymphocytes and level of IL-10 in peripheral blood of patients with systemic lupus erythematosus （SLE）, and analyze their effects in the disease.MethodsIn this study, 84 cases of patients with SLE were randomly selected and evaluated according to the activity index （SLEDAI）. These cases were divided into low activity group （SLEDAI〈9） and high activity group （SLEDAI≥9）. Ten healthy individuals were selected as the control group at the same time. The number of peripheral blood lymphocytes, B lymphocytes, CD5＋ B lymphocytes, erythrocyte sedimentation rate （ESR）,C3, C4 and interleukin （IL）-10 levels in serum were measured respectively and the correlation between the above indexes and SLEDAI and complement levels were analyzed. Pair-wise comparison of means of groups was conducted with one-way ANOVA. Comparison between the two groups was conducted by LSD-t test. Correlations between variables were carried out using Spearman＇s rank correlation test.ResultsThe total number of lymphocytes in SLE group was lower than that in normal control group （F=7.216, P〈0.001）; The number of CD19＋ B lymphocytes in SLE group was higher than that in normal control group （F=3.589, P=0.036）. The number of CD5＋ B lymphocytes of peripheral blood [（2.5±0.6）%] in patients with systemic lupus erythematosus was significantly lower than that in the normal control group [（3.2±0.8）%], but the difference was not statistically significant （t=3.412, P=0.698）. The number of CD5＋ B lymphocytes in the high activity group was significantly lower than that in the low activity group （t=7.365, P=0.027） and the normal control group（t=5.649, P=0.002）. The number of CD5＋ B lymphocytes was negatively correlated with SLEDAI score （r=-0.692, P=0.001） and positively associated with the level of complement 3 （r=0.305, P=0.038）, but not with complement 4 and ESR（P〉0.05）. In addition, the level of serum IL-10 in

关 键 词：红斑狼疮 系统性 B淋巴细胞亚群 白细胞介素.10 

分 类 号：R593.241[医药卫生—内科学]