流式细胞术监测原发性干燥综合征患者外周血B细胞免疫表型及临床意义  

Immunophenotype and clinical significance of B-lymphocyte cells in peripheral blood of patients with primary Sjogren′s syndrome by flow cytometry

作　　者：汤亚微 吴京学 王娇[1] 田瑶 朱杰[1] Tang Yawei;Wu Jingxue;Wang Jiao;Tian Yao;Zhu Jie(Department of Flow Cytometry Center,the Second Affiliated Hospital of Dalian Medical University,Dalian116023,China)

机构地区：[1]大连医科大学附属第二医院流式细胞中心,大连116023

出　　处：《中华检验医学杂志》2024年第12期1450-1458,共9页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金项目(82302047);辽宁省博士科研启动基金(2023-BS-160);大连医科大学附属第二医院“1+X”计划临床技术水平提升优势技术项目(2022LCJSYS03)。

摘　　要：目的检测原发性干燥综合征(pSS)患者外周血B细胞免疫表型, 探讨其在pSS中的变化及临床意义。方法回顾性病例对照研究。收集2023年3月1日至2024年2月28日在大连医科大学附属第二医院就诊的pSS患者25例(pSS组), 均为女性, 年龄(62.0±11.9)岁。同时期纳入25名女性健康体检者作为对照组(HC组), 年龄(57.6±11.2)岁。采用流式细胞术检测外周血B细胞亚群比例。pSS患者以年龄分为<60岁组(15例)、≥60岁组(10例);以ESSDAI评分分为ESSDAI评分<5分组(9例)、ESSDAI评分≥5分组(16例);以是否出现系统损伤分为无系统损伤组(7例)、合并系统损伤组(18例);以抗SSA抗体分为抗SSA抗体阴性组(7例)、抗SSA抗体阳性组(18例);以抗SSB抗体分为抗SSB抗体阴性组(17例)、抗SSB抗体阳性组(8例)。采用Mann-WhitneyU检验比较两组间B细胞亚群分布差异, Spearman相关性分析B细胞亚群比例与pSS患者实验室指标及ESSDAI评分相关性。结果与HC组相比, pSS组初始B细胞、CD19+CD20+B细胞、浆母细胞比例升高, 未转换记忆B细胞、类别转换记忆B细胞及调节性B细胞比例下降, 差异均有统计学意义(P均<0.05)。pSS患者中, ESSDAI评分≥5分组浆母细胞比例高于ESSDAI评分<5分组[1.20%(1.00%, 1.38%)比0.5%(0.38%, 0.65%), Z=2.416, P<0.05], 而调节性B细胞比例低于ESSDAI评分<5分组[2.50%(2.00%, 2.78%)比5.55%(3.58%, 7.10%), Z=2.775, P<0.05];合并系统损伤组未转换记忆B细胞比例低于无系统损伤组[1.50%(0.85%, 1.70%)%比2.45%(1.73%, 2.78%), Z=2.122, P<0.05]。Spearman相关性分析显示, pSS患者ESSDAI评分与浆母细胞比例呈正相关(r=0.431, P<0.05), 与调节性B细胞比例呈负相关(r=-0.413, P<0.05)。结论 pSS患者外周血浆母细胞比例升高、调节性B细胞比例下降, 与pSS疾病活动性高度相关, 浆母细胞及调节性B细胞可能在pSS发病中起着重要作用。Objective:To detect the immunophenotype of B cell subsets in peripheral blood of patients with primary Sjogren′s syndrome(pSS)and explore the clinical significance of B cell subsets in pSS.Methods:This is a retrospective case-control study.A total of 25 pSS patients treated in the Second Affiliated Hospital of Dalian Medical University from March 1st 2023 to February 28th 2024 were enrolled(pSS group).The mean age of the pSS group was 62.0±11.9 years old,including 25 female.Besides,25 female healthy subjects were selected as the control group(HC group)during the tudy period,with a mean age of 57.6±11.2 years old.Flow cytometry was used to detect the proportion of B cell subsets in peripheral blood.In our study,pSS patients were divided into<60 years old group(15 cases)and≥60 years old group(10 cases).pSS patients were divided into ESSDAI score<5 group(9 cases)and ESSDAI score≥5 group(16 cases)according to ESSDAI score.Besides,they were further divided into no system damage group(7 cases)and combined system damage group(18 cases).According to the expression of anti-SSA and anti-SSB antibodies,pSS patients were divided into anti-SSA antibody negative group(7 cases),anti-SSA antibody positive group(18 cases),anti-SSB negative group(17 cases)and anti-SSB positive group(8 cases).Mann-Whitney U test was used to compare the distribution difference of B cell subsets between the two groups,and Spearman correlation analysis was performed to analyze the correlation between B cell subsets and laboratory indicators and ESSDAI scores of pSS patients.Results:In comparison to the HC group,the pSS group exhibited a statistically significant increase in the proportions of na?ve B cells,CD19+CD20+B cells and plasmablast cells,alongside a decrease in the proportions of unswitched memory B cells,switched memory B cells and regulatory B cells,and the differences were statistically significant(all P<0.05).The proportion of plasmablast cells was significantly higher in the ESSDAI score≥5 group than that in the ESSDAI score<5 g

关 键 词：流式细胞术 原发性干燥综合征 B淋巴细胞 免疫表型 

分 类 号：R593.2[医药卫生—内科学]