系统性红斑狼疮患者免疫功能变化的初步研究

Pilot study of changes of immune function in patients with systemic lupus erythematosus

目的通过观察系统性红斑狼疮(SLE)患者免疫球蛋白、补体以及细胞因子的变化,探讨狼疮细胞和体液免疫功能对SLE的诊断、治疗和预后评估意义。方法 2013年2月至2014年2月分别采用免疫散射比浊法及酶联免疫吸附试验(ELISA)法检测25例SLE、12例非SLE自身免疫性疾病(AID)患者以及20例健康对照者血清中免疫球蛋白、补体及细胞因子[白介素6(IL-6)、肿瘤坏死因子α(TNF-α)]水平,初步了解SLE患者体液免疫变化情况。结果 SLE组血清免疫球蛋白G(IgG)和TNF-α水平[(13.94±5.99)g/L、(42.00±20.77)pg/L]较健康对照组[(11.26±1.35)g/L、(16.54±5.45)pg/L]明显升高,补体C3、C4水平[(0.69±0.22)、(0.15±0.11)g/L]较健康对照组[(0.97±0.20)、(0.30±0.02)g/L]、非SLE AID组[(1.16±0.22)、(0.28±0.05)g/L]明显降低,差异均有统计学意义(P<0.05),而血清IgM、IgA及IL-6水平较健康对照组,IgM、IL-6、TNF-α水平较非SLE AID组升高不明显,差异均无统计学意义(P>0.05)。结论 SLE患者存在免疫球蛋白升高及补体水平降低等体液免疫紊乱,对临床诊断和治疗有一定辅助意义。

Objective To investigate the function of cell immunity and humoral immunity of patients with systemic lupus erythematosus（SLE） on evaluation of SLE diagnosis and prognosis by systematic observation of the changes of immune globu-lin,complement in blood serum and cytokines. Methods Immune scatter turbidity and enzyme linked immunosorbent assay （ELISA） were adopted to detect 25 patients with SLE （SLE group）,12 patients without SLE autoimmune disease （non-SLE AID group） and 20 healthy controls（healthy control group） on immune globulin（Ig）,complement in blood serum,and cytokines[inter-leukin-6（IL-6）,tumor necrosis factor-α（TNF-α）] levels respectively from February 2013 to February 2014,to understand the changes of humoral immunity of SLE patients. Results The levels of IgG and TNF-αin the SLE group[（13.94±5.99）g/L,（42.00± 20.77）pg/L] were higher than those in the healthy control group [（11.26±1.35）g/L,（16.54±5.45）pg/L];the levels of C3 and C4 of complement in blood serum in the SLE group [（0.69±0.22）g/L,（0.15±0.11）g/L] decreased more obviously than those in the healthy control group[（0.97±0.20）g/L,（0.30±0.02）g/L] and non-SLE AID group[（1.16±0.22）g/L,（0.28±0.05）g/L],and the differences had statistical significance（P〈0.05）. However,the differences had no statistical significance on the levels of serum IgM,IgA and IL-6 between the SLE group and the healthy control group,and the levels of IgM,IL-6 and TNF-ɑbetween the SLE group and non-SLE group（P〉0.05）. Conclusion The SLE patients have dysfunction of humoral immunity including Ig increases and complement in blood serum decreases, which play an auxiliary role in the diagnosis and treatment of SLE.