梅毒患者外周血调节性B细胞亚群在治疗前后的变化研究  

Changes of regulatory B cells subsets before and after treatment in syphilis patients

作　　者：隆靖[1] 蔡胜男[1] 陈琛 伦文辉[1,2] 

机构地区：[1]北京大学地坛医院教学医院,北京100015 [2]首都医科大学附属北京地坛医院感染病科国家临床重点专科北京市中医管理局十二五重点建设专科,北京100015

出　　处：《中国艾滋病性病》2017年第10期938-942,共5页Chinese Journal of Aids & STD

基　　金：北京市卫生系统高层次卫生技术人才培养计划(2011-3-080)~~

摘　　要：目的探讨未经治疗的一期梅毒、二期梅毒和隐性梅毒患者外周血调节性B细胞亚群(CD19+CD24hi CD38hi B细胞、CD19+CD24hi CD27+B细胞)的百分比,及其在治疗后的变化情况。方法根据《梅毒诊疗指南(2014)》标准,2016年9月至2017年3月,在北京大学地坛医院教学医院皮肤性病科门诊的43例梅毒患者及8例健康对照。在治疗前及苄星青霉素治疗后2个月进行随访,对每次随访患者利用流式细胞技术检测外周血CD19+CD24hi CD38hi B细胞、CD19+CD24hi CD27+B细胞的百分比。结果 43例梅毒患者中,一期梅毒13例,二期梅毒16例,隐性梅毒14例。与健康对照组相比,未经治疗的一期、二期梅毒患者外周血CD19+CD24hi CD38hi B细胞百分比显著升高,CD19+CD24hi CD27+B细胞百分比显著降低,差异均有统计学意义(P<0.05);隐性梅毒患者与健康对照之间均无明显差异(P>0.05)。治疗后,一期梅毒、二期梅毒及隐性梅毒患者外周血CD19+CD24hi CD38hi B细胞百分比均显著降低,差异均有统计学意义(P<0.05);而CD19+CD24hi CD27+B细胞百分比均无明显改变,差异均无统计学意义(P>0.05)。相关性分析结果:梅毒患者外周血CD19+CD24hi CD38hi B细胞百分比与TRUST滴度呈正相关(P<0.01);CD19+CD24hi CD27+B细胞百分比与TRUST滴度呈负相关(P<0.01)。结论CD19+CD24hi CD38hi B细胞有可能是一期、二期梅毒患者的重要免疫学变化指标之一。苄星青霉素治疗能快速有效降低一期、二期梅毒患者外周血CD19+CD24hi CD38hi B细胞百分比。Abstract： Objective To observe the changes of regulatory B cell subsets（CD19＋ CD24hiCD38hiB cells, CD19＋ CD24hiCD27＋B cells） in peripheral blood of the primary, secondary and latent syphilis before and after treatment. Methods According to the syphilis treatment guidelines （2014）, 43 syphilis patients and 8 health controls were en- rolled from September 2016 to March 2017. Flow cytometry was used to detect the frequency of CD19＋ CD24h~ CD38h^B cells and CD19＋ CD24hiCD27＋ B cells in the peripheral blood before and after benzathine penicillin treat- ment. Results Out of the 43 cases there were 13 of primary syphilis, 16 of secondary syphilis and 14 of latent syph- ilis. Before treatment, the frequency of CD19＋ CD24hiCD38hiB cells in peripheral blood of primary and secondary syphilis patients was significantly higher than that of health controls （P〈0.05）, and the frequency of CD19＋ CD24hi CD27＋B cells in peripheral blood was significantly lower than that of health controls（P〈0.05）. However, there was no significant difference between patients of latent syphilis and health controls （P〈0.05）. After treatment, the frequency of CD19＋ CD24hiCD38UIB cells significantly decreased in all patients of the three groups （P〈0.05）. Fre- quency of CD19＋ CD24hiCD27＋ B cells was not significantly different in all three groups （P〈0.05） before and after treatment. The frequency of CD19＋ CD24hi CD38hi B cells was positively correlated with TRUST titer （P〈 0.01）, whereas the frequency of CD19＋ CD24hiCD27＋ B cells was negatively correlated （P〈0.01）. Conclu- sion CD19＋ CD24hiCD38hiB cells might be one of the important indicators to show immunological changes in the primary and secondary syphilis, and its frequency in primary and secondary syphilis can decrease just after the benzathine penicillin treatment.

关 键 词：梅毒患者 CD19+CD24hiCD38hiB细胞 CD19+CD24hiCD27+B细胞 苄星青霉素 

分 类 号：R759[医药卫生—皮肤病学与性病学]