系统性红斑狼疮患者CD154的表达与螺旋CT冠状动脉钙化积分的关系

Relationship between the expression of CD154 in patients with systemic lupus erythematosus and the calcification score of coronary arteries with spiral CT

目的:探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)患者外周血单个核细胞的CD154水平与冠状动脉钙化的关系。方法:选取80例SLE患者和80例健康对照组,采用流式细胞术检测CD154水平,采用多层螺旋CT(multi spiral computed tomography,MSCT)对冠状动脉钙化积分(coronar y arter y calcium score,CACs)进行检测。比较两组CD154及CACs水平,分析二者的相关性和SLE患者冠状动脉钙化的危险因素。结果:SLE患者外周血单个核细胞的CD154水平显著高于健康对照组,分别为26.19%(15.98%~34.18%)和5.89%(1.34%~8.29%),差异有统计学意义(P<0.05);CACs>400分的SLE患者外周血单个核细胞的CD154水平显著高于CACs≤400分的SLE患者,分别为34.24%(25.98%~39.18%)和20.21%(16.98%~24.18%),差异有统计学意义(P<0.05)。Spearman等级相关分析显示:SLE患者CD154水平与CACs呈明显的正相关(r=0.504,P<0.05)。多因素逐步回归分析显示:影响SLE患者CACs严重程度的因素有年龄、病程、糖尿病以及CD154。结论:SLE患者外周血单个核细胞的CD154水平较正常人显著升高;高水平的CD154与重度冠状动脉钙化相关。CD154可能参与SLE患者冠状动脉钙化的发生、发展。

Objective： To investigate the relationship between CD154 levels of peripheral blood mononuclear cells and coronary calcification in patients with systemic lupus erythematosus（SLE）. Methods： Total of 80 cases of SLE patients and 80 healthy cases were selected as research objects. We used flow cytometry to detect serum CD154 level and used multi spiral CT（MSCT） to detect coronary artery calcium score（CACs）. CD154 and CACs of two groups were compared. The correlation between the two groups and the risk factors of coronary artery calcification in SLE patients were analyzed. Results： The CD154 level of single nuclear cells in peripheral blood of SLE patients was significantly higher than that in healthy control group, 26.19%（15.98%–34.18%） and 5.89%（1.34%–8.29%） respectively, and the difference was statistically significant（P〈0.05）. The CD154 level of single nuclear cells in peripheral blood of CACs 400 scores was significantly higher than that in CACs ≤400 scores, 34.24%（25.98%–39.18%） and 20.21%（16.98%–24.18%） respectively, and the difference was statistically significant（P〈0.05）. Result of spearman rank correlation analysis showed that the CD154 level in SLE patients was significantly positively correlated with CACs（r=0.504, P〈0.05）. Result of multivariate progressive regression analysis showed that the factors influencing the severity of CACs in SLE patients included age, course of disease, diabetes and CD154. Conclusion： The CD154 level of individual nuclear cells in patients with SLE was significantly higher than that of normal patients. High levels of CD154 were associated with severe coronary calcification. CD154 may be involved in the development of coronary artery calcification in SLE patients.