CD4^(+)CD25^(+)Foxp3^(+)Treg及CD19^(+)CD69^(+)B细胞在狼疮性肾炎患者外周血中的水平变化及其与疾病活动度的关系  

The expression of CD4^(+)CD25^(+)Foxp3^(+)Treg and CD19^(+)CD69^(+)B cells in peripheral blood of patients with lupus nephritis and their relationship with disease activity

作　　者：向元兵[1] 吴禹希 孙敏[1] 胡耀[1] XIANG Yuanbing;WU Yuxi;SUN Min;HU Yao(Department of Nephrology,Affiliated Hospital of Chengdu University,Chengdu 618100,China)

机构地区：[1]成都大学附属医院肾内科,618100

出　　处：《免疫学杂志》2022年第7期633-638,共6页Immunological Journal

摘　　要：目的研究CD4^(+)CD25^(+)Foxp3^(+)Treg、CD19^(+)CD69^(+)B细胞在狼疮性肾炎中的水平变化与及其与病活动度的关系。方法选取我院于2018年10月至2020年10月收治的108例狼疮性肾炎患者作为研究组,根据系统性红斑狼疮的疾病活动指数(SLEDAI)分为轻度活动度组(38例)、中度活动度组(44例)、重度活动度组(26例),另选取同期于我院行肾穿刺活检证实为微小病变患者为对照组(50例)。检测受试者外周血中CD4^(+)CD25^(+)Foxp3^(+)Treg、CD19^(+)CD69^(+)B细胞水平,分析各组间细胞水平差异,采用ROC曲线分析CD4^(+)CD25^(+)Foxp3^(+)Treg、CD19^(+)CD69^(+)B细胞诊断狼疮性肾炎的价值,采用Pearson相关性分析各细胞与疾病活动度间的相关性。结果研究组患者外周血CD19^(+)CD69^(+)B细胞、TNF-α、CA199水平均显著高于对照组(P<0.05),而CD4^(+)CD25^(+)Foxp3^(+)Treg明显低于对照组(P<0.05)。不同严重程度狼疮性肾炎患者外周血CD4^(+)CD25^(+)Foxp3^(+)Treg、CD19^(+)CD69^(+)B细胞、TNF-α、CA199水平差异有统计学意义(P<0.05),其中重度组患者外周血CD19^(+)CD69^(+)B细胞、TNF-α、CA199水平最高。Pearson相关性分析显示,CD4^(+)CD25^(+)Foxp3^(+)Treg、CD19^(+)CD69^(+)B细胞分别与SLEDAI评分呈现负、正相关性,相关系数r分别为-0.458、0.468。采用ROC曲线分析显示,CD19^(+)CD69^(+)B细胞、CD4^(+)CD25^(+)Foxp3^(+)Treg诊断狼疮性肾炎的曲线下面积分别为0.801(95%CI=0.722~0.880)、0.839(95%CI=0.775~0.903)。两者联合诊断的曲线下面积为0.885(95%CI=0.826~0.944),高于单独检测(P<0.05)。结论CD4^(+)CD25^(+)Foxp3^(+)Treg、CD19^(+)CD69^(+)B细胞在狼疮性肾炎患者外周血中处于异常水平状态,且水平与疾病活动度相关,两者联合检测可作为诊断狼疮性肾炎的新指标。To study the levels of CD4^(+)CD25^(+)Foxp3^(+)Treg and CD19^(+)CD69^(+)B cells in lupus nephritis(LN)and their relationship with disease activity,total of 108 patients with LN in our hospital from October 2018 to October2020 were selected and divided into mild activity group(38 cases),moderate activity group(44 cases)and severe activity group(26 cases)according to the SLEDAI.In addition,50 patients with small renal lesions confirmed by renal biopsy in our hospital during the same period were selected as the control group.The levels of CD4^(+)CD25^(+)Foxp3^(+)Treg and CD19^(+)CD69^(+)B cells in the peripheral blood of subjects were detected,and the differences in cell levels among the groups were analyzed.ROC curve was used to analyze the value of CD4^(+)CD25^(+)Foxp3^(+)Treg and CD19^(+)CD69^(+)B cells in the diagnosis of LN,and Pearson correlation was used to analyze the correlation between CD4^(+)CD25^(+)Foxp3^(+)Treg/CD19^(+)CD69^(+)B cells cell and disease activity.Data showed that the peripheral blood CD19^(+)CD69^(+)B cells,TNF-αand CA199 levels of LN group were significantly higher than those of the control group(P<0.05),while the CD4^(+)CD25^(+)Foxp3^(+)Treg levels were significantly lower than the controlgroup(P<0.05).The levels of CD4^(+)CD25^(+)Foxp3^(+)Treg,CD19^(+)CD69^(+)B cells and TNF-α,CA199 in peripheral blood of patients with different severity of LN werestatistically different(P<0.05).Among them,the peripheral blood levels of CD19^(+)CD69^(+)B cells,TNF-αand CA199 of severe group patients were the highest.Pearson correlation analysis showed that CD4^(+)CD25^(+)Foxp3^(+)Treg andCD19^(+)CD69^(+)B cells were negatively and positively correlated with SLEDAI scores(r=-0.458 and 0.468),respectively;ROC curve analysis showed that the area under the curve for the diagnosis of LN by CD19^(+)CD69^(+)Bcells and CD4^(+)CD25^(+)Foxp3^(+)Treg were 0.801(95%CI=0.722-0.880)and 0.839(95%CI=0.775-0.903),respectively,while the area under the curve of the combined diagnosis was 0.885(95%CI=0.826-0.944),whichw

关 键 词：狼疮性肾炎 疾病活动度 CD4^(+)CD25^(+)Foxp3^(+)Treg CD19^(+)CD69^(+)B 相关性 

分 类 号：R593.242[医药卫生—内科学]