原发性干燥综合征并血小板减少患者外周血调节性B淋巴细胞表型特点分析  

Analysis of phenotypic characteristics of peripheral blood regulatory B lymphocytes in patients with primary Sj gren's syndrome and thrombocytopenia

作　　者：任艳 李思吟[2] 罗家昂 邹晋梅[2] 张羽[2] 董建玲[2] 田岚[2] 倪远飘 杨静[2] REN Yan;LI Siyin;LUO Jiaang;ZOU Jinmei;ZHANG Yu;DONG Jianling;TIAN Lan;NI Yuanpiao;YANG Jing(Chengdu Medical College,Chengdu 610550,China;Department of Rheumatology and Immunology,Mianyang Central Hospital,Mianyang 621000,Sichuan,China)

机构地区：[1]成都医学院,四川成都610550 [2]绵阳市中心医院风湿免疫科,四川绵阳621000

出　　处：《西部医学》2025年第3期403-407,共5页Medical Journal of West China

基　　金：广州市普康慈善基金会科研专项基金立项(PK-CF-2020-Z-1231)。

摘　　要：目的探讨原发性干燥综合征(pSS)并血小板(PLT)减少患者外周血中调节性B细胞(Bregs)的表达水平并分析其临床意义。方法选取2021年7月—2022年6月在绵阳市中心医院就诊的69例PSS患者为研究对象,根据患者是否出现免疫相关性PLT减少分为pSS并PLT减少组33例、pSS并PLT正常组36例。另选取同期30例体检健康人群作为健康对照组。采用流式细胞学技术分选淋巴细胞膜表面的CD分子,计算出3组受试者静脉血中Bregs百分比水平,即CD19^(+)CD24^(hi)CD38^(hi)B淋巴细胞、CD19^(+)CD5^(+)CD1d^(+)B细胞和CD19^(+)CD24^(+)CD27^(+)B细胞的占比水平。分析3组研究对象Bregs水平的差异。比较pSS并PLT减少组和pSS并PLT正常组患者的临床资料、实验室指标,用Logistic回归确定pSS并PLT减少的危险因素。结果pSS并PLT减少组及pSS并PLT正常组静脉血的CD19^(+)CD24^(+)CD27^(+)B细胞占比水平均较健康对照组下降(P<0.05)、CD19^(+)CD24^(hi)CD38^(hi)B细胞占比水平均较健康对照组增高(P<0.05);pSS并PLT正常组的CD19^(+)CD5^(+)CD1d^(+)B细胞占比水平较健康对照组增高(P<0.001),pSS并PLT减少组的CD19^(+)CD5^(+)CD1d^(+)B细胞占比水平较pSS并PLT正常组低(P<0.05);pSS并PLT减少组的血红蛋白(HGB)和补体C4较pSS并PLT正常组低(P<0.001,P<0.05)。Logistic回归分析显示,CD19^(+)CD5^(+)CD1d^(+)B细胞占比的下降是pSS出现PLT减少的危险因素(P<0.05)。结论pSS并PLT减少患者静脉血中的CD19^(+)CD5^(+)CD1d^(+)B细胞的占比与PLT正常组患者的占比有显著差异。CD19^(+)CD5^(+)CD1d^(+)B细胞占比水平的下降是pSS发生PLT计数减少的独立危险因素。Objective To investigate the expression levels of regulatory B cells(Bregs)in peripheral blood of patients with primary Sj gren’s syndrome(pSS)complicated with thrombocytopenia and analyze their clinical significance.Methods A total of 69 pSS patients treated at Mianyang Central Hospital from July 2021 to June 2022 were enrolled and divided into two groups:the pSS with thrombocytopenia group(n=33)and the pSS with normal platelet(PLT)group(n=36),based on the presence of immune-related thrombocytopenia.Additionally,30 healthy individuals from the same period were included as a control group.Flow cytometry was employed to isolate lymphocytes based on surface CD markers,and the percentage levels of Breg subsets in venous blood were calculated,including CD19^(+)CD24^(hi)CD38^(hi)B cells,CD19^(+)CD5^(+)CD1d^(+)B cells,and CD19^(+)CD24^(+)CD27^(+)B cells.Differences in Breg levels among the three groups were analyzed.Clinical data and laboratory parameters were compared between the pSS with thrombocytopenia and pSS with normal PLT groups,and logistic regression was used to identify risk factors for thrombocytopenia in pSS.Results Both the pSS with thrombocytopenia and pSS with normal PLT groups exhibited decreased percentages of CD19^(+)CD24^(+)CD27^(+)B cells compared to the healthy control group(P<0.05),while the percentage of CD19^(+)CD24^(hi)CD38^(hi)B cells was elevated in both pSS groups(P<0.05).The pSS with normal PLT group showed a higher percentage of CD19^(+)CD5^(+)CD1d^(+)B cells than the healthy control group(P<0.001),whereas the pSS with thrombocytopenia group had a lower percentage of CD19^(+)CD5^(+)CD1d^(+)B cells compared to the pSS with normal PLT group(P<0.05).Hemoglobin(HGB)and complement C4 levels were significantly lower in the pSS with thrombocytopenia group than in the pSS with normal PLT group(P<0.001 and P<0.05,respectively).Logistic regression analysis revealed that a reduced percentage of CD19^(+)CD5^(+)CD1d^(+)B cells was an independent risk factor for thrombocytopenia in pSS(P<0.05).Conclu

关 键 词：调节性B细胞 干燥综合征 免疫功能 血小板减少 流式细胞术 

分 类 号：R593.2[医药卫生—内科学]