系统性红斑狼疮患者外周血CD3^-CD16^+CD56^+NK细胞水平变化的临床意义  

Clinical significance of changes in peripheral blood CD3^-CD16^+CD56^+NK cells in patients with systemic lupus erythematosus

作　　者：仲华[1] 王朝辉[1] 林志强[1] 戴许阳 薄德映 王亚南 张磊[1] 翟志佳 焦路阳[1] ZHONG Hua;WANG Zhaohui;LIN Zhiqiang;DAI Xuyang;BO Deying;WANG Yanan;ZHANG Lei;ZHAI Zhijia;JIAO Luyang(Department of Clinical Laboratory,the First Affiliated Hospital Of Xinxiang Medical University,WeiHui,HeNan,China,453100)

机构地区：[1]新乡医学院第一附属医院检验科,河南卫辉453100

出　　处：《分子诊断与治疗杂志》2020年第11期1565-1569,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划项目(201802359)。

摘　　要：目的探究系统性红斑狼疮(SLE)患者外周血CD3-CD16^+CD56^+NK细胞水平变化及其临床意义。方法选择2017年3月至2019年6月本院风湿免疫科及肾内科收治的145例SLE患者及100例查体的健康体检者作为研究对象,测定两组受试者外周血CD3-CD16^+CD56^+NK细胞水平。收集SLE患者临床指标,根据SLE疾病活动性指数(SLEDAI)评分将患者分为活动组及非活动组,比较CD3-CD16^+CD56^+NK细胞水平差异并分析SLE患者CD3-CD16^+CD56^+NK细胞水平与临床参数的相关性。结果对照组受试者CD3-CD16^+CD56^+NK细胞计数、百分比均高于SLE组,比较差异均具有统计学意义(P<0.05)。活动组患者C3、C4补体水平及CD3-CD16^+CD56^+NK细胞计数、百分比均低于非活动组,差异具有统计学意义(P<0.05),SLEDAI评分、C反应蛋白(CRP)、血沉(ESR)、抗dsDNA抗体、抗C1q抗体水平高于非活动组,差异具有统计学意义(P<0.05)。Pearson相关性分析示,CD3-CD16^+CD56^+NK细胞水平与SLEDAI、CRP水平呈负相关(P<0.05),与C3、C4补体水平呈正相关(P<0.05);Logistic多因素分析示,C3补体、ESR、抗dsDNA抗体、CD3-CD16^+CD56^+NK细胞计数及百分比与SLE活动度独立相关(P<0.05)。ROC曲线示,CD3-CD16^+CD56^+NK细胞计数及CD3-CD16^+CD56^+NK细胞百分比评估SLE活动度的曲线下面积分别为0.752、0.794,当截点值为144.08个/μL、11.44%时,约登指数最大。结论 SLE患者存在CD3-CD16^+CD56^+NK细胞水平的降低,且其水平与SLE患者活动度密切相关,检测其水平或可为SLE患者病情评估提供一定参考。Objective To explore the changes of peripheral blood CD3-CD16^+CD56^+NK cells in patients with systemic lupus erythematosus(SLE)and their clinical significance.Methods A total of 145 patients with SLE who were admitted to the Department of Rheumatology and Nephrology in the hospital between March 2017 and June 2019,and 100 healthy subjects were selected as the research group.The levels of peripheral blood CD3-CD16^+CD56^+NK cells in both groups were measured,and clinical indexes of patients with SLE were collected.Patients were divided into active group and inactive group according to the SLEDAI score.The levels of peripheral blood CD3-CD16^+CD56^+NK cells in different groups were compared,and their correlation with clinical parameters in patients with SLE was analyzed.Results CD3-CD16^+CD56^+NK cell count and percentage in the control group were high than those in the SLE group.The differences of CD3-CD16^+CD56^+NK cell count and percentage between the groups were statistically significant(P<0.05).Complement C3 and C4 levels,CD3-CD16^+CD56^+NK cell count and percentage in the active group were lower than those in the inactive group(P<0.05).SLEDAI score,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),antidsDNA antibody and anti-C1 q antibody levels in the active group were higher than those in the inactive group(P<0.05).Pearson correlation analysis showed that levels of CD3-CD16^+CD56^+NK cells were negatively correlated with SLEDAI score and CRP levels(P<0.05),but were positively correlated with complement C3 and C4 levels(P<0.05).Multivariate Logistic analysis showed that complement C3,ESR,anti-dsDNA antibody,CD3-CD16^+CD56^+NK cell count and percentage were independently correlated with the activity of SLE(P<0.05).ROC curve showed that the area under the curve values of CD3-CD16^+CD56^+NK cell count and percentage for evaluating the activity of SLE were 0.752 and 0.794,respectively.When the cut-off values were 144.08 cells/μL and 11.44%,the Youden index was the largest.Conclusion There is a decrea

关 键 词：系统性红斑狼疮 自然杀伤细胞 系统性红斑狼疮疾病活动指数 

分 类 号：R593.241[医药卫生—内科学]