系统性红斑狼疮患者Th1/Th2淋巴细胞类型与疾病活动指数的相关性

Th1/Th2 balance related to disease activity in systemic lupus erythematosus

目的 探讨Th1/Th2细胞类型与疾病活动指数之间的关系。方法 利用流式细胞分析法对系统性红斑狼疮 (SLE)患者无尿蛋白组 2 1例 ,有尿蛋白组 2 7例和健康志愿者 15名外周血中淋巴细胞的胞内细胞因子 (INF γ、IL 4)和表面抗原 (CD4)进行分析。结果 SLE患者组和无尿蛋白组与健康志愿者Th1/Th2细胞比值无明显区别 (P >0 0 5 ) ,但SLE尿蛋白组患者Th1/Th2细胞比值显著高于SLE无尿蛋白组和健康志愿组 (P <0 0 5 )。尿蛋白组患者Th1和Th1/Th2比值与疾病活动指数之间呈明显的正相关 (P <0 0 5 )。结论 虽然SLE被认为是一种Th2细胞占优势的疾病 ,Th1/Th2的比值目前研究未表现这些细胞为优势 ;相反 ,在SLE患者中狼疮肾炎有强的Th1优势 ,其程度与疾病活动性密切相关。

Objective To investigate the Th1/Th2 balance of peripheral Th cells in patients with systrmic lupus erythematosus (SLE) and try to understand the role of Th1/Th2 in the pathogenesis of SLE.Method Flow cytometric analysis was employed for intracellular cytokines (IFN γ,IL 4) and surface antigen (CD4) of T cells in the peripheral blood of patients and healthy volunteers.SLE patients were divided into two groups:SLE without proteinuria (group I, n =21) and SLE with proteinuria (group Ⅱ, n =27).Results There was no difference in the mean Th1∶Th2 ratio between SLE patients (group Ⅰ and Ⅱ) and healthy control.However,the mean value in SLE with proteinuria (group Ⅱ) was significantly higher than that in SLE without proteinuria and healthy control.There was significant positive correlation between Th1,Th1/Th2 and SLE disease activity in SLE with proteinuria ( P <0 05).Conclusion Although SLE is considered a disease in which Th2 cells predominate,the Th1/Th2 balance of peripheral Th cells in SLE patients in the present study does not show a predominance of these cells.In contrast,among SLE patients with lupus nephritis,there is a strong predominance of Th1.The increased Th1 is related to disease activity.