系统性红斑狼疮患者外周血T淋巴细胞的激活状态

T Lymphocytes Activity in Peripheral Blood of Patients with Systemic Lupus Erythematosus

目的探讨系统性红斑狼疮(SLE)患者外周血中T淋巴细胞激活状态及其在发生发展过程中所起的作用。方法收集本院门诊和住院治疗的60例SLE患者设为SLE组,另有40例于同期来本院查体的健康体检者设为正常对照组。采用双色流式细胞术测定SLE患者组和正常对照组外周血CD38/CD3分子水平;放免法和间接免疫荧光法检测其血清抗ds DNA抗体;间接免疫荧光法检测其抗核抗体;免疫散射比浊法检测其补体C3和C4水平;速率酶法检测血清肌酐水平。再根据疾病活动指数评分结果将SLE组患者分为活动期组和稳定期组,根据相关标准还分为肾炎组和非肾炎组。结果 SLE患者外周血CD38/CD3分子水平(724±139分子/细胞),显著高于健康对照组(641±110分子/细胞);活动期SLE患者CD38/CD3分子水平(905±138分子/细胞)显著高于非活动期患者(671±111分子/细胞);狼疮肾炎患者CD38/CD3分子水平(911±146分子/细胞)显著高于非肾炎患者(681±127分子/细胞),差别均具有统计学意义(P均<0.05)。狼疮患者CD38/CD3分子水平与肌酐水平(r=0.75,P<0.01)、抗ds DNA抗体(r=0.78,P<0.01)及SLEDAI评分(r=0.67,P<0.01)显著相关,而与C3和C4水平(r=-0.19,-0.24;P>0.05)无相关性。结论 CD38/CD3分子水平与反应SLE活动度的指标密切相关,T淋巴细胞激活状态在SLE特别是狼疮肾炎的发生、发展中可能起重要作用。本研究仅对女性患者进行检测分析,CD38/CD3分子水平与SLE男性患者疾病发生发展的相关性还有待进一步研究。

Objective To clarify the role of T lymphocytes from peripheral blood in the process of systemic lupus ery- thematosus＇s （SLE）development by investigating the cell＇s activation. Methods Sixty patients with SLE who came to hospital for treatments were sampled into group SLE. Additionally ,40 people coming for healthy examination during the same period were grouped into control. Peripheral blood was collected from trial par- ticipants of two groups. Both CD38 and CD3 were detected by two. Color fluorescence activated cell sorter; Anti dsDNA were analyzed in the method of radio y and indirect immunofluorescence;Antinucle- ar antibodies （ANA） were tested by indirect immunofluorescence;C3/C4 were checked by Immune scatter- ing turbidimetry;Creatinine were examined by rate-enzymatic method. According to SLEDAI, patients were divided into stable group and active group, meanwhile, according to related standard, patients were divided into nephritis group and group without nephritis. Results CD38/CD3 were significantly increased in pa- tients with SLE （724 ± 139molecules/cell） compared with that in normal control （641 ± 110 molecules/ cell,P 〈 0.05 ）. The expression level of CD38/CD3 in the active patients （905 ± 138 molecules/cell）with SLE was extraordinary higher than the patients in the non - active phase （671 ± 111 molecules/cell, P 〈 0.05 ） ;The expression level of CD38/CD3 in patients with nephritis （911 ± 146 molecules/cell ）was ex- traordinary higher than the patients without nephritis （681 ± 127 molecules/cell, P 〈 0.05 ）. SLE patients＇CD38/CD3 had a dramatic relationship with Creatinine, anti dsDNA, SLEDAI （ P 〈 0.01 ） and no correla- tion with C3/C4 （P 〉 0.05 ）. Conclusion The expression level of CD38/CD3 had a dramatic relationship with SLE activity. The abnormal aetivation of T lymphocytes are possible to have an important funetion in the onset and development of SLE and LN espeeially. This study was operated on female partieipants only. A further research on the relationship between CD38/CD3 and male pateints with SLE is needed afterwards.