系统性红斑狼疮不同疾病时期外周血中ILC、B细胞、T淋巴细胞亚群水平变化及临床意义

Changes and clinical significance of ILC,B cell,and T lymphocyte subsets in peripheral blood in different stages of systemic lupus erythematosus

目的探讨系统性红斑狼疮(SLE)不同疾病时期外周血中固有淋巴细胞(ILC)、B细胞、T淋巴细胞亚群水平变化及临床意义。方法前瞻性选择2020年1月至2023年1月神木市医院收治的90例SLE患者进行研究(观察组),采用系统性红斑狼疮疾病活动性指数(SLEDAI)评分评价所有SLE患者的病情活动程度,其中活动组(SLEDAI≥5分)32例,非活动组(SLEDAI<5分)58例,并选择同期在我院体检的90例健康者作为对照组。比较观察组与对照组,以及观察组不同疾病活动度患者的外周血ILC1、ILC2、ILC3、记忆B细胞、静止B细胞和CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)的表达水平。采用Pearson相关分析法分析ILC、B细胞、T淋巴细胞亚群水平与疾病活动度的相关性。结果观察组患者的ILC1、记忆B细胞、CD8^(+)水平分别为(20.35±2.51)%、(25.45±6.70)%、(36.20±2.93)%,明显高于对照组的(14.55±1.20)%、(21.79±6.53)%、(31.28±2.74)%,ILC2、ILC3、静止B细胞、CD4^(+)、CD4^(+)/CD8^(+)水平分别为(10.12±1.34)%、(6.20±1.12)%、(60.23±8.14)%、(30.85±3.30)%、0.81±0.07,明显低于对照组的(42.49±3.48)%、(14.36±2.41)%、(42.05±3.38)%、(42.05±3.38)%、1.53±0.10,差异均有统计学意义(P<0.05);活动组患者的ILC1、记忆B细胞、CD8^(+)水平分别为(22.40±2.53)%、(32.02±9.12)%、(39.36±3.16)%,明显高于非活动组的(18.64±2.04)%、(26.88±6.45)%、(34.90±2.20)%,ILC2、ILC3、静止B细胞、CD4^(+)、CD4^(+)/CD8^(+)水平分别为(8.66±0.81)%、(5.73±1.10)%、(56.86±10.42)%、(27.96±3.10)%、0.68±0.05,明显低于非活动组的(19.68±1.85)%、(8.50±1.84)%、(62.03±11.25)%、(34.50±3.62)%、0.98±0.12,差异均有统计学意义(P<0.05);经Pearson相关分析结果显示,ILC1、记忆B细胞、CD8^(+)水平与疾病活动度均呈正相关(r=0.726、0.549、0.500,P<0.05),LC2、ILC3、静止B细胞、CD4^(+)、CD4^(+)/CD8^(+)水平与疾病活动度均呈负相关(r=-0.503、-0.715、-0.705、-0.668、-0.734,P<0.05)。结论SLE患者外周血中ILC、B细胞、T淋巴细胞亚群水平与疾病活动度密切相关,对其监测有助于评估疾病进展和制定治疗方案。

Objective To investigate the changes of innate lymphoid cells(ILC),B cells,and T lymphocyte subsets in peripheral blood of systemic lupus erythematosus(SLE)in different disease periods and their clinical signifi-cance.Methods A prospective study was conducted on 90 SLE patients admitted to Shenmu City Hospital from Janu-ary 2020 to January 2023(observation group).The systemic lupus erythematosus disease activity index(SLEDAI)score was used to evaluate the degree of disease activity in all SLE patients,including 32 patients in the active group(SLE-DAI≥5)and 58 patients in the inactive group(SLEDAI<5).Ninety healthy individuals who underwent physical exami-nations in the hospital during the same period were selected as the control group.The levels of ILC1,ILC2,ILC3,memo-ry B cells,static B cells,CD4^(+),CD8^(+),CD4^(+)/CD8^(+)in peripheral blood of patients with different disease activity were com-pared between the observation group and the control group.Pearson correlation analysis was used to analyze the correla-tion between ILC,B cell,T lymphocyte subsets and disease activity.Results The levels of ILC1,memory B cells,and CD8^(+)in the observation group were(20.35±2.51)%,(25.45±6.70)%,and(36.20±2.93)%,which were significantly high-er than(14.55±1.20)%,(21.79±6.53)%,and(31.28±2.74)%in the control group;the levels of ILC2,ILC3,quiescent B cells,CD4^(+),CD4^(+)/CD8^(+)were(10.12±1.34)%,(6.20±1.12)%,(60.23±8.14)%,(30.85±3.30)%,0.81±0.07,which were sig-nificantly lower than(42.49±3.48)%,(14.36±2.41)%,(42.05±3.38)%,(42.05±3.38)%,1.53±0.10 in the control group;the differences were statistically significant(P<0.05).The levels of ILC1,memory B cells,and CD8^(+)in SLE group were(22.40±2.53)%,(32.02±9.12)%,and(39.36±3.16)%,which were significantly higher than(18.64±2.04)%,(26.88±6.45)%,(34.90±2.20)%in inactive SLE group(P<0.05),and the levels of ILC2,ILC3,static B cells,CD4^(+),CD4^(+)/CD8^(+)were(8.66±0.81)%,(5.73±1.10)%,(56.86±10.42)%,(27.96±3.10)%,0.68±0.05,which were significantly lower than(19.68±1.85)%,(8.50±1.84)%,(62.03±11.25)%,(34.50±3.62)%,0.98±0.12 of SLE inactive group(P<0.05).Pearson cor-relation analysis showed that the levels of ILC1,memory B cells,and CD8^(+)were positively correlated with disease activ-ity(r=0.726,0.549,0.500,P<0.05),while the levels of LC2,ILC3,static B cells,CD4^(+),CD4^(+)/CD8^(+)were negatively cor-related with disease activity(r=-0.503,-0.715,-0.705,-0.668,-0.734,P<0.05).Conclusion The levels of ILC,B cell,and T lymphocyte subsets in peripheral blood of SLE patients are closely related to disease activity,and their moni-toring is helpful to evaluate disease progression and formulate treatment plan.