系统性红斑狼疮患者sCD40L水平变化及临床意义

The levels of sCD40L in SLE patients and their clinical significance.

目的对系统性红斑狼疮(SLE)患者血清中可溶性CD40配体(sCD40L)的含量变化及临床意义进行讨论。同时分析血小板减少组SLE患者与血小板正常组SLE患者血清中sCD40L的含量差别。初步探讨血清和血浆中sCD40L浓度有无差异。分析SLE患者血清中sCD40L的含量与系统性红斑狼疮疾病活动度评分(SLEDAI评分)有无相关性。方法用酶联免疫吸附法检测25例SLE患者和15例正常人血清中及18例正常人血浆中sCD40L的浓度。结果①血小板正常组SLE患者血清中的sCD40L浓度明显高于正常对照组和血小板减少组SLE患者。②SLE患者血清sCD40L浓度、血小板正常组SLE患者血清中sCD40L浓度、血小板减少组SLE患者血清中sCD40L浓度与SLEDAI评分均无相关性。③SLE患者血清中sCD40L浓度与血小板计数呈正相关。④发现正常人血清中sCD40L的浓度明显高于血浆中的sCD40L的浓度。结论 SLE患者血清中sCD40L浓度较正常人高可能参与SLE的发生发展过程。血小板计数对血清中sCD40L浓度有一定程度的影响,且SLE患者血清中sCD40L与SLEDAI评分无相关性,在临床上sCD40L不适合作为监测SLE疾病的活动度的指标。

Objective To investigate the alteration of serum soluble CD40 ligand（sCD40L） level in systemic lupus erythematosus（SLE） patients and analyze the difference of serum sCD40L levels between SLE patients with normal platelet counts and those with lower platelet counts in order to determine whether serum sCD40L levels in SLE patients relate to SLEDAI scores.Methods（1）ELISA method was used to measure serum and plasma sCD40L levels.Results ①Serum sCD40L level in SLE patients with normal platelet counts was higher than the patients with lower platelet counts and normal controls.②Serum sCD40L level from SLE patients did not correlate with the SLE Disease Activity Index（SLEDAI） score.③There was significant positive correlation between sCD40L values and platelet counts in SLE patients.④In normal controls,serum sCD40L level was significantly higher than plasma sCD40L level.Conclusion The observation that the level of serum sCD40L in SLE patients is higher than that in normal controls indicates sCD40L may participate in the occurrence and development of SLE.In view that platelet counts have some effects on the levels of serum sCD40L and there is no correlation between the level of serum sCD40L and SLEDAI score,serum sCD40L concentration is not a good index of disease activity in SLE patients in clinical practice.