外周血T淋巴细胞亚群对系统性红斑狼疮及狼疮性肾炎患者疾病转归的预测价值  

The predictive value of T lymphocyte subsets on the prognosis of systemic lupus erythematosus and lupus nephritis

作　　者：李红莉[1] 孙丽华 贾红红 LI Hongli;SUN Lihua;JIA Honghong(Department of Nephrology,Yan'an People's Hospital,Yan'an 716000,China)

机构地区：[1]延安市人民医院肾内科,延安716000

出　　处：《国际免疫学杂志》2024年第6期611-616,共6页International Journal of Immunology

基　　金：延安大学附属医院科学技术研究发展计划(2022PT-17)。

摘　　要：目的探究外周血T淋巴细胞亚群水平对系统性红斑狼疮(systemic lupus erythematosus,SLE)及狼疮性肾炎患者疾病转归的预测价值。方法选择78例SLE患者(狼疮组)和60例健康人(对照组)为研究对象,根据实验结果再将狼疮组患者分为轻度活动期组、中度活动期组和重度活动期组,预后良好组和预后不良组,狼疮性肾炎组和非狼疮性肾炎组。比较各组研究对象外周血中T淋巴细胞亚群CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)的比值;分析SLE患者外周血中T淋巴细胞亚群与C反应蛋白(C-reactive protein,CRP)和红细胞沉降率(erythrocyte sedimentation rate,ESR)的相关性。结果狼疮组患者的CD3^(+)细胞水平和CD4^(+)细胞水平及CD4^(+)/CD8^(+)比值均低于对照组[(61.82±4.03)%比(75.34±4.39)%,(32.73±2.98)%比(45.03±3.24)%,(0.84±0.13)比(1.53±0.20),t值分别为18.80、23.14、24.49,P值均<0.05],狼疮组患者CD8^(+)细胞水平高于对照组患[(39.04±3.53)%比(29.43±3.05)%,t=16.81,P<0.05];随着SLEDAI评分的增加,SLE患者外周血中CD3^(+)细胞水平和CD4^(+)细胞水平及CD4^(+)/CD8^(+)比值均明显降低,CD8^(+)细胞水平明显升高(F值分别为144.74、1074.93、239.83、236.27,P值均<0.05);狼疮性肾炎组患者外周血中CD3^(+)细胞水平和CD4^(+)细胞水平及CD4^(+)/CD8^(+)比值明显低于非狼疮性肾炎组[(58.47±4.11)%比(64.69±3.88)%、(30.04±3.02)%比(35.03±2.11)%、(0.71±0.19)比(0.96±0.10),t值分别为6.87、8.55、7.42,P值均<0.05]CD8^(+)细胞水平高于非狼疮肾炎组患者CD8^(+)细胞水平[(42.03±2.78)%比(36.48±2.77)%,t=8.81,P<0.05];预后不良组患者外周血中CD3^(+)细胞水平和CD4^(+)细胞水平及CD4^(+)/CD8^(+)比值低于预后良好组患者[(55.27±2.01)%比(65.49±3.80)%、(28.57±2.46)%比(34.39±2.03)%、(0.64±0.16)比(0.95±0.23),t值分别为13.21、11.25、6.32,P值均<0.05]预后不良组患者CD8^(+)细胞水平高于预后良好组患者CD8^(+)细胞水平[(44.42±2.32)%比(36.03±2.03)%,t=Objective Study predictive value of T lymphocyte subsets levels on the prognosis of systemic lupus erythematosus(SLE)and lupus nephritis(LN).Methods Seventy-eight SLE patients(lupus group)and 60 healthy people(control group)were selected as the research objects.According to the experimental results,the lupus group was further divided into mild active group,moderate active group and severe active group,good prognosis group and poor prognosis group,lupus nephritis group and non-lupus nephritis group.The peripheral blood T lymphocyte subsets CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)of each group were compared.The correlation of T lymphocyte subsets with C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)in peripheral blood of SLE patients was analyzed.Results The levels of CD3^(+)and CD4^(+)and CD4^(+)/CD8^(+)in lupus group were lower than those in control group[(61.82±4.03)%vs(75.34±4.39)%,(32.73±2.98)%vs(45.03±3.24)%,(0.84±0.13)vs(1.53±0.20),t values was 18.80,23.14,24.49,respectively,all P values<0.05].The level of CD8^(+)cells in lupus group was higher than that in control group[(39.04±3.53)%vs(29.43±3.05)%,t=16.81,P<0.05].With the increase of SLEDAI score,the percentage of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in peripheral blood of SLE patients decreased,while the percentage of CD8^(+)cells increased significantly(F values were 144.74,1074.93,239.83,236.27,all P values<0.05).The levels of CD3^(+)cells,CD4^(+)cells and CD4^(+)/CD8^(+)ratio in peripheral blood of patients in lupus nephritis group were significantly lower than those in non-lupus nephritis group[(58.47±4.11)%vs(64.69±3.88)%、(30.04±3.02)%vs(35.03±2.11)%、(0.71±0.19)vs(0.96±0.10),t values were 6.87,8.55,7.42,respectively,all P values<0.05].CD8^(+)in LN patients were significantly higher than those in non-LN patients[(42.03±2.78)%vs(36.48±2.77)%,t=8.81,P<0.05].The levels of CD3^(+)cells and CD4^(+)and CD4^(+)/CD8^(+)in peripheral blood of patients with poor prognosis were significantly lower than those of patients with good

关 键 词：T淋巴细胞亚群 SLE 狼疮性肾炎 预后 

分 类 号：R593.24[医药卫生—内科学]