文章摘要
狼疮肾炎患者外周血淋巴细胞亚群分布及其临床意义
Distribution of lymphocyte subsets in peripheral blood ofpatients with lupus nephritis and its clinical significance
投稿时间：2024-01-04  
DOI：10.3969/j.issn.1000-0399.2024.07.004
中文关键词: 狼疮肾炎  T淋巴细胞  B淋巴细胞  NK淋巴细胞  系统性红斑狼疮
英文关键词: Lupus nephritis  T lymphocyte  Blymphocyte  NK lymphocyte  Systemic lupus erythematosus
基金项目:
作者单位E-mail
夏莹莹 230001 安徽合肥 安徽医科大学附属省立医院风湿免疫科  
蔡明龙 230001 安徽合肥 中国科学技术大学附属第一医院风湿免疫科  
金慧芷 230001 安徽合肥 中国科学技术大学附属第一医院风湿免疫科  
马艳 230001 安徽合肥 中国科学技术大学附属第一医院风湿免疫科  
汪国生 230001 安徽合肥 中国科学技术大学附属第一医院风湿免疫科  
厉小梅 230001 安徽合肥 中国科学技术大学附属第一医院风湿免疫科  
陈竹 230001 安徽合肥 安徽医科大学附属省立医院风湿免疫科
230001 安徽合肥 中国科学技术大学附属第一医院风湿免疫科 		doczchen@ustc.edu.cn 
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中文摘要:
      目的 分析狼疮肾炎（LN）患者外周血淋巴细胞亚群的分布及差异，并探讨其临床意义。方法 回顾性分析 2020 年1 月至 2022 年 12 月就诊于安徽省立医院，诊断为系统性红斑狼疮（SLE）并行肾穿刺活检术经病理确诊为 LN 的 106 例患者临床、病理资料及相关实验室指标。流式细胞仪测定其外周血淋巴细胞亚群的比例，分析不同淋巴细胞亚群分布及其与临床指标的关系。结果 106 例 LN 患者中，CD3+T 细胞比例为（75.58±10.04）%，其中 CD4+T 细胞比例降低有 36 例（33.96%），CD8+T 细胞比例升高 55 例（51.89%），CD19+B 细胞比例降低 23 例（21.70%），升高 13 例（12.26%），NK 细胞比例降低 45 例（42.45%）。CD3+T 细胞比例与活动性指数（AI）、系统性红斑狼疮活动指数（SLEDAI）、免疫球蛋白 M（IgM）、抗 C1q 抗体均呈负相关（r=-0.250、-0.241、-0.207、-0.291；P<0.05），与补体 C3 呈正相关（r=0.238；P<0.05）。CD4+T 细胞比例与尿 β2 微球蛋白呈负相关（r=-0.259；P<0.05），与免疫球蛋白 A（IgA）呈正相关（r=0.193；P<0.05）。CD8+T 细胞比例与免疫球蛋白 G（IgG）、IgA、IgM、血沉（ESR）呈负相关（r=-0.216、-0.248、-0.279、-0.228；P<0.05）。CD19+B 细胞比例与补体 C3、C4 呈负相关（r=-0.257、-0.214；P<0.05），而与 SLEDAI、IgG、抗核小体抗体、抗 C1q 抗体、抗双链DNA（dsDNA）抗体呈正相关（r=0.200、0.204、0.241、0.271、0.264；P<0.05）。CD16+CD56+NK 细胞与各临床表型之间无明显相关性（P>0.05）。结论 LN 患者的 T、B 淋巴细胞亚群比例与免疫球蛋白、补体、狼疮活动性指标、SLEDAI 等存在相关性，对疾病预后有指导意义，测定 T、B 淋巴细胞亚群比例可能有助于判断 LN 的严重程度。
英文摘要:
      Objective To analyze the distribution and difference of peripheral blood lymphocyte subsets in patients with lupus nephritis (LN), and to explore the clinical significance. Methods There is a retrospective analysis was performed on the data of 106 patients who were diagnosed with systemic lupus erythematosus (SLE) and pathologically confirmed as LN by renal biopsy from January 2020 to December 2022 in Anhui Provincial Hospital. The data included clinical data, pathological data, and related laboratory indicators. The proportion of peripheral blood lymphocyte subsets was measured by flow cytometry, and the distribution of different lymphocyte subsets and their relationship with clinical phenotype was analyzed. Results Among the 106 patients with LN, the proportion of CD3+T cells was (75.6±10.0)%, of which, the decrease in the proportion of CD4+T cells accounted for 36cases(34.0%), the increase in the proportion of CD8+T cells accounted for 55 cases(51.9%), the decrease in the proportion of CD19+B cells accounted for 23 cases(21.7%), and the increase of it accounted for 13 cases (12.3%), and the decrease in the proportion of NK cells accounted for 45 cases(42.5%). The proportion of CD3+T cells was negatively correlated with activity index(AI), systemic lupus erythematosus activity index(SLEDAI) , immunoglobulin M(IgM) and anti-C1q antibody (r=-0.250, -0.241, -0.207, -0.291；P<0.05), while positively correlated with complement C3(r=0.238；P< 0.05). The proportion of CD4+T cells was negatively correlated with urinary β2-microglobulin (r=-0.259；P<0.05) and positively correlated with IgA (r= 0.193；P< 0.05). The proportion of CD8+T cells was negatively correlated with IgG, IgA, IgM anderythrocyte sedimentation rate(ESR)(r=-0.216, -0.248, -0.279, -0.228；P< 0.05). The proportion of CD19+B cells was negatively correlated with complement C3 and C4 (r=-0.257, -0.214；P< 0.05) , while positively correlated with SLEDAI, IgG, anti-nucleosome antibody, anti-C1q antibody and anti-dsDNA antibody (r=0.200, 0.204, 0.241, 0.271, 0.264；P< 0.05). There was no significant correlation between CD16+CD56+NK cells and clinical phenotypes(P>0.05). Conclusions The proportion of T and B lymphocyte subsetsin LN patients is correlated with the clinical indicators such as immunoglobulin, complement, lupus activity index and SLEDAI, which is meaningful for disease prognosis, and the determination of T and B lymphocyte subsets ratio may help to determine the severity of LN.
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