系统性红斑狼疮合并肺动脉高压患者外周血T淋巴细胞亚群水平变化及临床意义

Changes of peripheral blood T lymphocyte subsets in patients with systemic lupus erythematosus complicated with pulmonary arterial hypertension and its clinical significance

目的分析检测T淋巴细胞亚群对系统性红斑狼疮(systemic lupus erythematosus,SLE)合并肺动脉高压(pulmonaryarterial hypertension,PAH)的临床意义。方法选取2022年3月—2023年10月郑州大学第一附属医院收治的178例系统性红斑狼疮患者,其中78例活动期SLE合并PAH患者为合并组,50例单纯活动期SLE患者为未合并组,50例单纯非活动期SLE患者为对照组,回顾性分析入组者临床资料,包括性别、吸烟史、饮酒史、病程、年龄、体质量指数(BMI)及实验室指标等。对比未合并组与合并组各项实验室指标,并比较不同疾病活动度患者的T淋巴细胞亚群,以Pearson法分析SLE合并PAH与外周血T淋巴细胞亚群的相关性,并以logistic回归法分析SLE合并PAH的影响因素。结果合并组CD4^(+)、CD4^(+)/CD8^(+)水平分别为(28.99±7.54)及(0.75±0.24),均低于未合并组,合并组CD8^(+)水平(38.84±6.89),高于未合并组,差异有统计学意义(P<0.05);未合并组CD4^(+)/CD8^(+)水平(0.97±0.38)低于对照组(1.33±0.56),合并组CD8^(+)水平(33.59±7.41)高于对照组(28.66±4.54),差异有统计学意义(P<0.05);Pearson相关性分析显示,CD4^(+)、CD4^(+)/CD8^(+)与SLE合并PAH呈负相关,CD8^(+)与SLE合并PAH呈正相关(P<0.05);logistic分析显示,高水平CD4^(+)、CD4^(+)/CD8^(+)是SLE合并PAH的保护因素,高水平CD8^(+)则是危险因素(P<0.05)。结论相较于单纯活动期或非活动期SLE患者,SLE合并PAH患者外周血T淋巴细胞亚群存在异常表达,可通过检测T淋巴细胞亚群预测SLE合并PAH的风险,以指导临床治疗。

Objective To analysis and detection of T lymphocyte subsets in systemic lupus erythematosus(SLE systemiclupuserythematosus,)merge pulmonary hypertension(pulmonaryarterial hypertension,PAH)of clinical significance.Methods A retrospective cohort study was conducted to select 178 patients with systemic lupus erythematosus admitted to the First Affiliated Hospital of Zhengzhou University from March 2022 to October 2023,of which 78 patients with active SLE combined with PAH were included in the combined group,50 patients with simple active SLE were included in the uncombined group,and 50 patients with simple inactive SLE were included in the control group.Clinical data including gender,smoking history,drinking history,course of disease,age,body mass index(BMI)and laboratory indexes were retrospectively analyzed.Various laboratory indicators were compared between the uncombined group and the combined group,and T lymphocyte subsets of patients with different disease activity were compared.The correlation between SLE complicated with PAH and peripheral blood T lymphocyte subsets was analyzed by Perason method,and the influencing factors of SLE complicated with PAH were analyzed by logistic regression method.Results The levels of CD4^(+)and CD4^(+)/CD8^(+)in the combined group were(28.99±7.54)and(0.75±0.24),respectively,lower than those in the non-combined group,and CD8^(+)level was(38.84±6.89)higher than that in the non-combined group(P<0.05).CD4^(+)/CD8^(+)level(0.97±0.38)was lower than that of control group(1.33±0.56),and CD8^(+)level(33.59±7.41)was higher than that of control group(28.66±4.54)(P<0.05).Pearson correlation analysis showed that CD4^(+),CD4^(+)/CD8^(+)were negatively correlated with SLE combined PAH,and CD8^(+)was positively correlated with SLE combined PAH(P<0.05).Logistic analysis showed that high levels of CD4^(+)and CD4^(+)/CD8^(+)were protective factors for SLE combined with PAH,while high levels of CD8^(+)were risk factors(P<0.05).Conclusion Compared with patients with active or inactive SLE alone,there is abnormal expression of T lymphocyte subsets in peripheral blood of patients with SLE complicated with PAH.Detection of T lymphocyte subsets can predict the risk of SLE complicated with PAH to guide clinical treatment.