T细胞亚群、IL-6、IL-18及IFN-γ水平变化与系统性红斑狼疮发病的相关性及可能的作用机制分析

Analysis on the correlation between the changes of T cell subset,IL-6,IL-18 and IFN-γ and the morbidity of systemic lupus erythematosus and on its possible pathogenesis

目的:探讨T淋巴细胞亚群、IL-6、IL-18及IFN-γ水平变化与系统性红斑狼疮(SLE)发病相关性及在SLE发病中的作用机制。方法:选取在医院诊治的65例SLE患者纳入SLE组,另选65名健康体检者纳入健康对照组;SLE组根据患者疾病活动指数评分结果分为活动期组(28例)和稳定期组(37例),采用流式细胞术对各组外周血T淋巴细胞亚群CD3+、CD4+和CD8+进行检测分析,应用双抗体夹心酶联免疫吸附试验(ELISA)方法测定血浆的IL-6、IL-18和IFN-γ水平,免疫球蛋白采用透射比浊法在全自动生化仪上检测。结果:SLE组外周血CD3+、CD4+和CD8+的淋巴细胞水平明显低于健康对照组,差异有统计学意义(t=-14.60,t=-13.75,t=-10.97;P<0.01);SLE组Ig G、Ig A及Ig M明显高于健康对照组,差异有统计学意义(t=7.50,t=8.78,t=7.14;P<0.01);且活动期组较非活动期组增高更明显,差异有统计学意义(t=9.86,t=4.40,t=6.57;P<0.01),SLE组IL-6、IL-18及IFN-γ水平明显高于健康对照组,差异有统计学意义(t=6.27,t=-4.85,t=-5.80;P<0.01),且活动期组较非活动期组增高更明显,差异有统计学意义(t=6.27,t=-4.85,t=-5.80;P<0.01)。结论:SLE患者T淋巴细胞亚群及细胞因子、免疫球蛋白水平与健康人群相比变化明显,并且与SLE的病情活动密切相关,可能在SLE的发病中发挥重要作用。三者联合检测,有利于监测病情及指导治疗。

Objective: To investigate the correlation between the changes of T lymphocyte subsets, interleukin-6(IL-6), IL-18 and IFN-γ and the morbidity of systemic lupus erythematosus(SLE), and its pathogenesis in SLE. Methods: 65 patients with SLE were divided into SLE group, and 65 healthy persons who passed physical examination were divided into control group. Patients of SLE group were divided into active stage group(28 cases) and stable stage group(37 cases) in accordance with the score results of disease activity index of them. And flow cytometry was adopted to implement detection analysis for T lymphocytes(CD3+, CD4+ and CD8+) of peripheral blood, and double-antibody sandwich ELISA was used to detect IL-6, IL-8 and IFN-γ levels. Besides, transmission turbidimetry was used to detect immunoglobulin by using automatic biochemical analyzer. Results: The levels of lymphocytes(CD3+, CD4+ and CD8+) of SLE group were significantly lower than those of healthy control group(t=-14.60, t=-13.75, t=-10.97, P<0.01), respectively. And Ig G, IgA, and IgM of SLE group were significantly higher than those of control group(t=7.50, t=8.78, t=7.14, P<0.01), respectively. And the increases of them of active stage group were significantly higher than those of stable stage group(t=9.86, t=4.40, t=6.57, P<0.01), respectively. And the IL-6, IL-8 and IFN-γ of SLE group were significantly higher than those of control group(t=6.27, t=-4.85, t=-5.80, P<0.01), respectively, and the increases of them of active stage group were significantly higher than those of stable stage group(t=6.27, t=-4.85, t=-5.80, P<0.01). Conclusion: The changes of levels of T lymphocyte subsets, cytokines and immunoglobulin of patients with SLE are significance compared with those of healthy persons, and these changes have closely relation with disease activity of SLE, and these indicators might play important role in the pathogenesis of SLE. Besides, the joint detection with three kinds of indicators would contribute to monitor state of illness and guide treatment.