血液狼疮细胞形态学变化的观察与临床价值

Observation of blood lupus cell morphology and its clinical significance

目的:通过观察系统性红斑狼疮患者外周血中狼疮细胞形态学的变化,判断系统性红斑狼疮疾病严重性和活动性的临床意义。方法:采用改良血块法进行了118例系统性红斑狼疮患者狼疮细胞形态的观察,同时用系统性红斑狼疮病情活动性经典生物标记抗体,抗双链DNA抗体、抗核小体抗体及补体作对照比较。结果:狼疮细胞存在有多种典型形态及其结构异常的特殊狼疮细胞,均匀体小至笔尖大至巨核细胞出现裂隙不规则,细胞多聚集成片结构清晰可辨,有的似串葡萄、巨核细胞、双叶、多叶及降落伞等特殊形态。65例系统性红斑狼疮患者特殊型狼疮细胞的检出与抗双链DNA抗体、抗核小体抗体和SLEDAI呈显著正相关,与C3和C4水平呈明显负相关。结论:狼疮细胞特殊形态的观察,对SLE疾病的严重性和活动性判断具有更简便快速,准确可靠优于生物抗体标记法的特殊价值。

Objective To evaluate the clinical value and the activity of systemic lupus erythematosus diseas was adopted to observe 118 cases of systemic lupus eryt to the use of biological labeled antibody of systemic lup of special lupus cell in judging the ponderance e. Methods The modified blood clots method hematosus with special lupus cell, in addition us erythematosus activity： anti-double strand DNA（dsDNA） antibody, anti-nucleosome antibody （AnuA）, complement and the systemic lupus erythematosus disease activity index（SLEDAI） for comparisons. Results There were more abnormal cell morphologies of lupus cell. Small to the tip of a pencil to large cracks appeared irregular megkaryocgte. Cell gathered to pieces and the structure can also distinguish. Some like series grapes, megkaryocgte, double-leaf, multi-leaf and parachute, etc. Detection of special lupus cell, anti- dsDNA antibodies in lupus cells, chromatin and SLEDAI of 65 cases of systemic lupus erythematosus was positively correlated, but C3 and C4 level was negatively correlated. Conclusion The special lupus erythematosus cell is the product of systemic lupus erythematosus development. After researching the classical biological labeled antibody of the activity of systemic lupus erythematosus and the SLEDAI, it is proved that lupus erythematosus cell is easier, more quickly, accurate and economical than the method of biological antibody marker to the estimation of seriousness and activity of systemic lupus erythematosus.