CD19^(+)CD24^(+)CD27^(+)调节性B细胞及IL-10、IL-34与系统性红斑狼疮中医证型的关系

Relationship betweenCD19^(+)CD24^(+)CD27^(+)regulatory B cells and IL-10,IL-34 and systemic lupus erythematosus Chinese medicine patterns

目的:探讨CD19^(+)CD24^(+)CD27^(+)调节性B细胞(Bregs细胞)及白细胞介素(IL)-10、IL-34与系统性红斑狼疮(SLE)中医证型的关系。方法:选取2022年4月~2024年4月在本院接受治疗的117例SLE患者为研究组,并纳入同期进行体检的86名健康体检者为对照组,检测对比两组的CD19^(+)CD24^(+)CD27^(+)Bregs细胞中CD24^(high) CD27^(+)比例、CD24^(mid) CD27^(+)比例以及血清IL-10、IL-34水平。另将研究组根据中医辨证分型分为热毒炽盛证、肝肾阴虚证、脾肾阳虚证,检测对比不同中医证型患者间CD24^(high) CD27^(+)比例、CD24^(mid) CD27^(+)比例、IL-10、IL-34、肾功能及系统性红斑狼疮疾病活动指数(SLEDAI)的差异。结果:研究组的CD24^(high) CD27^(+)比例、CD24^(mid) CD27^(+)比例、IL-10、IL-34水平均高于对照组,差异有统计学意义(P<0.05)。117例SLE患者中热毒炽盛证有49例、肝肾阴虚证33例、脾肾阳虚证35例。CD24^(high) CD27^(+)比例、CD24^(mid) CD27^(+)比例、IL-10、IL-34水平及SLEDAI评分均在肝肾阴虚证、脾肾阳虚证、热毒炽盛证中依次上升,差异有统计学意义(P<0.05);脾肾阳虚证患者的血清肌酐、尿素氮、24h尿蛋白定量均高于热毒炽盛证及肝肾阴虚证患者(P<0.05)。结论:SLE患者血清CD19^(+)CD24^(+)CD27^(+)Bregs细胞、IL-10、IL-34水平均与中医证型有关,可作为中医辨证论治的辅助指标。

Objective:To investigate the relationship between CD19^(+)CD24^(+)CD27^(+)regulatory B cells(Bregs cells)and interleukin(IL)-10,IL-34 and systemic lupus erythematosus(SLE)in Chinese medicine.Methods:117 cases SLE patients who received treatment in our hospital from April 2022 to April 2024 were selected as the study group.86 healthy medical examiners who underwent physical examination during the same period were included as the control group.And tests were performed to compare the CD19^(+)CD24^(+)CD27^(+)proportion of CD24^(high) CD27^(+),the proportion of CD24^(mid) CD27^(+)in CD19^(+)CD24^(+)CD27^(+)Bregs cells,and the serum IL-10,IL-34 levels.In addition,the study group was divided into Heat and Toxin Blazing syndrome,Liver and Kidney Yin Deficiency syndrome,and Spleen and Kidney Yang Deficiency syndrome according to the TCM dialectic typing,and the differences in CD24^(high) CD27^(+)ratio,CD24^(mid) CD27^(+)ratio,IL-10,IL-34,renal function,and Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)were detected and compared among the patients with different TCM syndromes.Results:The CD24^(high) CD27^(+)ratio,CD24^(mid) CD27^(+)ratio,IL-10 and IL-34 levels were^(high)er in the study group than in the control group,and the difference was statistically significant(P<0.05).Among the 117 patients with SLE,there were 49 cases of heat-toxin blazing syndrome,33 cases of liver-kidney yin deficiency syndrome,and 35 cases of spleen-kidney yang deficiency syndrome.CD24^(high) CD27^(+)ratio,CD24^(mid) CD27^(+)ratio,levels of IL-10,IL-34,and SLEDAI scores were all statistically significant,with a statistically significant difference,as they were in the order of increasing in the liver-kidney yin deficiency syndrome,the spleen-kidney yang deficiency syndrome,and heat-toxin blazing syndrome(P<0.05).Serum creatinine,urea nitrogen and 24h urine protein quantification were^(high)er in patients with spleen and kidney yang deficiency than in patients with heat-toxin incandescence and liver and kidney yin deficiency(P<0.05).Conclusion:Serum CD19^(+)CD24^(+)CD27^(+)Bregs cells,IL-10 and IL-34 levels in SLE patients are all related to TCM patterns and can be used as auxiliary indicators for TCM diagnosis and treatment.