视神经脊髓炎谱系疾病患者外周血CD19^(+)CD27^(+)B细胞、CD4^(-)CD8^(-)双阴性T细胞及相关细胞因子水平与复发关系的初步研究  

A preliminary study on the relationship between peripheral blood CD19^(+)CD27^(+)B cells,CD4^(-)CD8^(-)double-negative T cells,related cytokines and recurrence in patients with neuromyelitis optica spectrum disorders

作　　者：王丽丽 蒋玙珠 李鹏辉 彭越 李书剑 Wang Lili;Jiang Yuzhu;Li Penghui;Peng Yue;Li Shujian(Department of Neurology,Henan Provincial People′s Hospital,People′s Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院、郑州大学人民医院神经内科,郑州450003

出　　处：《中华神经科杂志》2023年第7期747-754,共8页Chinese Journal of Neurology

摘　　要：目的初步分析视神经脊髓炎谱系疾病(NMOSD)复发患者外周血CD19^(+)CD27^(+)B细胞比例、CD4^(-)CD8^(-)双阴性T细胞及相关细胞因子水平与复发的关系。方法回顾性分析2019年1月至2021年1月河南省人民医院收治的72例NMOSD患者临床资料。根据患者治疗后1年内是否复发,分为未复发组(n=30)和复发组(n=42)。收集患者性别、年龄、入院时扩展功能障碍状态量表(EDSS)评分等资料。采用全自动生化仪检测血清甘油三酯、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)水平。采用全自动程序化蛋白分析仪检测脑脊液总蛋白水平。采用免疫散射比浊法检测脑脊液免疫球蛋白(Ig)G和IgM。采用流式细胞术测定外周血CD19^(+)CD27^(+)B细胞、CD4^(-)CD8^(-)双阴性T细胞数目。采用酶联免疫吸附法检测血清白细胞介素(IL)-6、IL-10和IL-2。结果复发组患者EDSS评分、中性粒细胞、水通道蛋白4(AQP4)抗体阳性比例、自身免疫抗体阳性比例明显高于未复发组(均P<0.05)。两组血清甘油三酯、HDL-C、LDL-C、ApoB、ApoA1水平,脑脊液总蛋白、IgG和IgM水平比较,差异均无统计学意义(均P>0.05)。复发组患者CD19+B细胞、CD19^(+)CD27^(+)B细胞、CD4^(-)CD8^(-)双阴性T细胞的比例分别为(1.21±0.12)%、(1.61±0.17)%和(1.39±0.25)%,均显著高于未复发组[分别为(0.85±0.07)%、(1.25±0.12)%和(0.89±0.22)%,t=15.51、3.89、12.06,均P<0.05]。复发组患者CD19+B细胞、CD19^(+)CD27^(+)B细胞、CD4^(-)CD8^(-)双阴性T细胞数目分别为(289.50±17.64)×10^(6)个/L、(4.67±0.03)×10^(6)个/L和(64.78±6.53)×10^(6)个/L,均显著高于未复发组[分别为(254.56±15.34)×10^(6)个/L、(3.18±0.03)×10^(6)个/L和(47.82±4.83)×10^(6)个/L,t=14.27、4.26、12.06,均P<0.05]。复发组患者血清IL-10水平为(18.56±1.97)ng/ml,低于未复发组患者的(24.72±2.52)ng/ml(t=11.64,P<0.05),IL-6和IL-2水平分�Objective To preliminarily analyze the relationship between peripheral blood CD19^(+)CD27^(+)B cells,CD4^(-)CD8^(-)double-negative T cells,related cytokines and recurrence in patients with neuromyelitis optica spectrum disorders(NMOSD).Methods A retrospective analysis was performed on the clinical data of 72 patients with NMOSD admitted to Henan Provincial People′s Hospital between January 2019 and January 2021.According to presence or absence of recurrence within 1 year after treatment,they were divided into non-recurrence group(n=30)and recurrence group(n=42).The data such as gender,age and score of Extended Disability Status Scale(EDSS)at admission were collected.The levels of serum triglyceride(TG),total cholesterol(CHO),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A(ApoA)1 and apolipoprotein B(ApoB)were detected by full-automatic biochemical analyzer.The level of total protein in cerebrospinal fluid was detected by full-automatic programmed protein analyzer.The levels of immunoglobulin(Ig)G and IgM in cerebrospinal fluid were detected by immunoturbidimetry.The counts of peripheral blood CD19^(+)CD27^(+)B cells and CD4^(-)CD8^(-)double-negative T cells were detected by flow cytometry.The levels of serum interleukin(IL)-6,IL-10 and IL-2 were detected by enzyme-linked immunosorbent assay.Results EDSS score,neutrophils,proportions of cases with positive aquaporin 4(AQP4)antibody and autoimmune antibody in the recurrence group were significantly higher than those in the non-recurrence group(all P<0.05).There was no statistically significant difference in serum TG,HDL-C,LDH-C,ApoB,ApoA1,total protein in cerebrospinal fluid,IgG or IgM between the non-recurrence group and the recurrence group(allP>0.05).The proportions of CD19+B cells,CD19^(+)CD27^(+)B cells and CD4^(-)CD8^(-)double-negative T cells in the recurrence group were(1.21±0.12)%,(1.61±0.17)%and(1.39±0.25)%,significantly higher than those in the non-recurrence group[(0.85±0.07)%,(1.25±0.12)%,(

关 键 词：视神经脊髓炎 细胞因子类 B细胞 T细胞 初步研究 

分 类 号：R744.52[医药卫生—神经病学与精神病学]