外周血淋巴细胞亚群及免疫球蛋白在诊断儿童皮肌炎中的临床价值研究  

Clinical value of peripheral blood lymphocyte subsets and immunoglobulin in the diagnosis of dermatomyositis in children

作　　者：梁可青 叶志成[1] 刘金虎 吴茗 LIANG Keqing;YE Zhicheng;LIU Jinhu;WU Ming(Department of Clinical Laboratory,Children's Hospital of Fudan University,National Children's Medical Center,Shanghai 201102,China)

机构地区：[1]国家儿童医学中心复旦大学附属儿科医院,上海201102

出　　处：《国际检验医学杂志》2023年第8期1002-1006,共5页International Journal of Laboratory Medicine

摘　　要：目的探究儿童皮肌炎患儿外周血淋巴细胞亚群、免疫球蛋白和补体的变化及临床价值。方法收取2019年6月至2022年6月初诊于国家儿童中心复旦大学附属儿科医院的儿童皮肌炎患儿84例作为JDM组,并收取86例健康儿童外周血作为对照组。使用流式细胞术(FACS)检测两组外周血各淋巴细胞亚群百分比及绝对计数;免疫比浊法检测两组血清IgG、IgM、IgA、TIgE和补体C3、C4及CH50水平。结果相较于对照组,JDM组外周血CD4^(+)和CD8^(+)T细胞百分比明显升高,CD16^(+)CD56^(+)百分比降低,且各淋巴细胞亚群计数也降低(P<0.05)。此外,JDM组血清IgG、IgM、IgA、TIgE和补体C4水平明显高于对照组(P<0.05)。绘制上述免疫标志物的受试者工作特征(ROC)曲线,分析发现CD16^(+)CD56^(+)百分比和绝对计数及IgG对于儿童皮肌炎的诊断能力较强。血清IgG水平升高,外周血CD16^(+)CD56^(+)百分比及IgA水平降低为诊断儿童皮肌炎的独立危险因素(P<0.05)。结论外周血淋巴细胞亚群、免疫球蛋白及补体的联合检测有助于儿童皮肌炎的早期诊断,特别是CD16^(+)CD56^(+)百分比降低,血清IgG和IgA水平升高对于诊断儿童皮肌炎具有重要指导意义。Objective To explore the changes and diagnostic value of peripheral blood lymphocyte subsets,immunoglobulin and complement in children with dermatomyositis.Methods The peripheral blood was collected from 84 children with dermatomyositis(JDM group)and 86 healthy children(control group)who were admitted to the Children's Hospital of Fudan University,National Children's Medical Center,from June 2019 to June 2022.Both the absolute count and percentages of lymphocyte subsets in peripheral blood were analyzed via flow cytometry(FACS).The levels of serum IgG,IgM,IgA,TIgE and C3,C4,CH50 were detected by immunoturbidimetry.Results Compared with control group,the percentages of CD4^(+)and CD8^(+)T cells in peripheral blood of children in JDM group were significantly increased,but the percentage of CD16^(+)CD56^(+)decreased,and the counts of each lymphocyte subset were also decreased.In addition,serum IgG,IgM,IgA,TIgE and complement C4 in research group were significantly higher than those in control group.The receiver operating characteristic(ROC)curve analysis showed that the absolute count and percentage of CD16^(+)CD56^(+),and IgG had strong diagnostic ability for dermatomyositis.The elevation of serum IgG level,and decreased percentage of CD16^(+)CD56^(+)and decreased level of IgA in peripheral blood were independent factors for diagnosing dermatomyositis in children(P<0.05).Conclusion Combined detection of lymphocyte subsets,immunoglobulin and complement in peripheral blood is helpful for early diagnose of dermatomyositis in children.Especially,the decrease in the percentage of CD16^(+)CD56^(+)and the increase in serum IgG and IgA levels have important guiding significance for the diagnosis of pediatric dermatomyositis.

关 键 词：皮肌炎 淋巴细胞亚群 免疫球蛋白 补体 IgG 自然杀伤细胞 

分 类 号：R446.1[医药卫生—诊断学]