狼疮性肾炎并发感染患者外周血淋巴细胞亚群变化及其临床意义

Changes of peripheral blood lymphocyte subsets in lupus nephritis patients complicated with infection and their clinical significance

目的探究狼疮性肾炎并发感染患者外周血CD_(4)^(+)、CD_(8)^(+)、CD_(16)CD_(56)、CD_(19)细胞变化及其临床意义。方法选取2018年1月-2021年3月河南科技大学第一附属医院收治的狼疮性肾炎并发感染患者86例为感染组、单纯狼疮性肾炎未发生感染患者65例为无感染组,并募集同期体检健康者60名为对照组,采用流式细胞术检测各组外周血淋巴细胞亚群CD_(4)^(+)、CD_(8)^(+)、CD_(16)CD_(56)、CD_(19)比例,酶联免疫吸附法检测外周血白细胞介素(IL)-6、IL-1β、肿瘤坏死因子α(TNF-α)含量。结果狼疮性肾炎患者CD_(4)^(+)、CD_(16)CD_(56)比例及CD_(4)^(+)/CD_(8)^(+)水平低于对照组,CD_(8)^(+)、CD_(19)比例、血清IL-6、IL-1β、TNF-α水平高于对照组(P<0.05),且感染组CD_(4)^(+)、CD_(16)CD_(56)比例及CD_(4)^(+)/CD_(8)^(+)水平低于无感染组,CD_(8)^(+)、CD_(19)比例、IL-6、IL-1β、TNF-α水平高于无感染组(P<0.05)。对于狼疮性肾炎合并感染患者,肾功能正常组CD_(16)CD_(56)比例、CD_(4)^(+)/CD_(8)^(+)水平高于肾功能不全组,CD_(19)比例、IL-6、IL-1β、TNF-α水平低于肾功能不全组(P<0.05)。结论狼疮性肾炎并发感染患者外周血淋巴细胞亚群分布紊乱、炎性因子水平升高,可作为患者肾功能潜在的评估指标。

OBJECTIVE To explore the changes of peripheral blood CD_(4)^(+),CD_(8)^(+),CD_(16)CD_(56) and CDcells in lupus nephritis patients complicated with infection and analyze the clinical significance.METHODS A total of 86 lupus nephritis patients who were complicated with infection and treated in The First Affiliated Hospital of Henan University of Science and Technology from Jan 2018 to Mar 2021 were assigned as the infection group,65 lupus nephritis patients who were not complicated with infection were assigned as the no infection group,meanwhile,60 healthy people who received physical examination were chosen as the control group.The percentages of peripheral blood lymphocyte subsets CD_(4)^(+),CD_(8)^(+),CD_(16)CD_(56) and CDwere detected by using flow cytometry,and the levels of peripheral blood interleukin(IL)-6,IL-1βand tumor necrosis factorα(TNF-α)were detected by means of enzyme-linked immunosorbent assay.RESULTS The percentages of CD_(4)^(+) and CD_(16)CD_(56) as well as CD_(4)^(+)/CD_(8)^(+) level were significantly lower in the lupus nephritis patients than in the control group;the percentages of CD_(16)and CD_(56) and the levels of serum IL-6,IL-1βand TNF-αwere significantly higher in the lupus nephritis patients than in the control group(P<0.05);the percentages of CDand CD_(16)CD_(56) and the CD_(4)^(+)/CD_(8)^(+) level of the infection group were significantly higher than those of the no infection group(P<0.05).Among the lupus nephritis patients complicated with infection,the percentage of CD_(16)CD_(56) and the CD/CDlevel of the normal renal function group were significantly higher than those of the renal insufficiency group,while the percentage of CD_(8)^(+) and the levels of IL-6,IL-1βand TNF-αof the normal renal function group were significantly lower than those of the renal insufficiency group(P<0.05).CONCLUSION The lupus nephritis patients complicated with infection are characterized by disordered distribution of lymphocyte subsets in peripheral blood and rise of levels of inflammatory factors,and the above indexes can be used for assessment of renal function.