补体活化及T淋巴细胞亚群在泌尿系结石合并感染中的变化  

Change of complement activation and T lymphocyte subsets in urinary calculi patients complicated with infection

作　　者：唐霞燕 陈英[1] 陈智洋 朱德胜 刘磊 TANG Xia-yan;CHEN Ying;CHEN Zhi-yang;ZHU De-sheng;LIU Lei(Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua,Zhejiang 321000,China;不详)

机构地区：[1]浙江大学医学院附属金华医院碎石科,浙江金华321000 [2]浙江大学医学院附属金华医院设备科,浙江金华321000 [3]浙江大学医学院附属金华医院泌尿外科,浙江金华321000 [4]浙江达恩医疗检测实验室,浙江金华321017

出　　处：《中华医院感染学杂志》2024年第18期2770-2773,共4页Chinese Journal of Nosocomiology

基　　金：浙江省卫生健康委基金资助项目(2022RC285);金华市中心医院中青年科研启动基金(JY2020-2-11)。

摘　　要：目的研究补体活化介导的免疫学效应在泌尿系结石合并感染中的变化。方法随机选取2021年8月-2023年8月于金华市中心医院就诊的泌尿系结石合并泌尿系感染患者30例(感染组)和未合并泌尿系感染患者30例(结石组),收集两组患者一般资料,检测T淋巴细胞激活水平,分析血清与尿液中不同途径补体激活水平,并进行聚类分析。结果与结石组比较,感染组患者CD_(3)^(+)、CD_(4)^(+)T淋巴细胞亚群激活水平[(59.39±3.96)%vs.(62.73±4.37)%、(34.92±2.66)%vs.(39.77±3.29)%]降低,CD_(8)^(+)T淋巴细胞亚群激活水平[(22.66±4.41)%vs.(20.42±2.74)%]升高,CD_(4)^(+)/CD_(8)^(+)比值[(1.60±0.35)vs.(1.99±0.34)]降低,比较均有统计学差异(P<0.05);感染组患者血清与尿液补体系统C1q、C4d、C3a、C5a、MBL和Sc5b9表达水平均升高(P<0.05),根据补体表达水平可将研究对象明显聚为两类。结论泌尿系结石合并感染患者体内出现显著补体系统活化,补体活化产物与感染有相关性,可能参与结石的发生与发展。OBJECTIVE To observe the change of complement activation-mediated immunological effect in urinary calculi patients complicated with infection.METHODS A total of 30 urinary calculi patients complicated with urinary system infection and 30 calculi patients without urinary system infection who were treated in Jinhua Central Hospital from Aug 2021 to Aug 2023 were randomly chosen as the research subjects and were respectively assigned as the infection group and the calculi group.The baseline data were collected from the two groups of patients,the activation level of T lymphocyte was detected,the activation levels of different pathways of complements in serum and urine were observed,and cluster analysis was performed.RESULTS The activation levels of T lymphocyte subsets CD_(3)^(+)and CD_(4)^(+)of the infection group were respectively[(59.39±3.96)%vs.(62.73±4.37)%,(34.92±2.66)%vs.(39.77±3.29)%]lower than those of the calculi group,the activation level of T lymphocyte subset CD_(8)^(+)T of the infection group was[(22.66±4.41)%vs.(20.42±2.74)%]higher than that of the calculi group,the ratio of CD_(4)^(+)to CD_(8)^(+)of the infection group was[(1.60±0.35)vs.(1.99±0.34)]lower than that of the calculi group(P<0.05).The expression levels of complement systems C1q,C4d,C3a,C5a,MBL and Sc5b9 in both serum and urine were elevated in the infection group(P<0.05);the research subjects could be remarkably grouped into 2 categories.CONCLUSION The urinary calculi patients complicated with infection show remarkable activation of complement systems.The complement activation product is associated with the infection,which may be involved in occurrence and development of the calculi.

关 键 词：补体活化 泌尿系统结石 感染 聚类 

分 类 号：R691.4[医药卫生—泌尿科学]