儿童系统性红斑狼疮患者外周血淋巴细胞亚群与疾病活动的研究

Association between peripheral blood lymphocyte subsets and disease activity in children with systemic lupus erythematosus

目的探讨儿童系统性红斑狼疮(SLE)患儿外周血中淋巴细胞亚群的变化及临床意义。方法采用流式细胞术检测59例SLE患儿及52名健康对照组患儿的外周血淋巴细胞亚群T细胞、B细胞、Th细胞、Tc细胞、NK细胞和总淋巴细胞数,并对结果进行比较,同时分析SLE患儿外周血淋巴细胞亚群与SLE疾病活动指数(SLEDAI)的相关性及其与狼疮肾炎、补体的相关关系。结果与健康对照组相比,SLE患儿Th细胞和Th百分比、NK细胞和NK细胞百分比及Th/Tc比值明显降低,而B细胞百分比、Tc细胞百分比增高,差异均有统计学意义(P<0.05);SLE患儿B细胞与SLEDAI评分呈正相关,NK细胞百分比与SLE评分呈负相关(P<0.05);狼疮肾炎组患儿的T细胞、Tc细胞计数和Tc细胞百分比均明显高于无狼疮肾炎的患儿,而狼疮肾炎组患儿Th细胞百分比、Th/Tc比值和NK细胞、NK细胞百分比明显低于无狼疮肾炎的患儿(P<0.05);补体降低组患儿的B细胞和B细胞百分比及SLEDAI评分均明显高于补体正常组(P<0.05)。结论 SLE患儿外周血淋巴细胞亚群存在异常,淋巴细胞亚群与SLEDAI评分、狼疮肾炎和补体之间存在显著的相关性,表明淋巴细胞亚群可能反映SLE患儿病情的严重程度。

Objective To explore the profile of lymphocyte subsets in children with systemic lupus erythemato-sus （SLE）. Methods Flow cytometry was employed to detect the lymphocyte subsets, including the T, B, Th, Tc and NK cells and total lymphocyte cells in peripheral blood of children with SLE （ n=59） and age-and sex-matched healthy children （n=52）. The relationship between peripheral blood lymphocyte subsets and SLE disease activity score （SLEDAI）, lupus nephritis, complement in children with SLE were analyzed. Results Compared with control group, children with SLE were characterized by markedly reduced number of Th and NK cells, the percentage of Th and NK cells and Th/Tc ratio yet an increased percentage of Tc and B cells （all P〈0.05）. The SLEDAI score was positively correlated with B cell count but negatively correlated with percentage of NK cells （both P〈0.05）. Children with lupus nephritis yielded notably higher T and Tc cell count and Tc cell percentage yet lower Th cell percentage, Th/Tc ratio, NK cell count and NK cell percentage than non-lupus nephritis group （all P〈0.05）. Reduced levels of complements were associated with a higher B cell count, B cell percentage and SLEDAI score in children with SLE （ P〈0.05）. Con-clusion The aberrant lymphocyte subsets in peripheral blood of children with SLE are associated with the SLEDAI scores, lupus nephritis and complement, suggesting that the lymphocyte subsets may reflect disease severity in chil-dren with SLE.