青岛大学学报（医学版）2023，Vol.59Issue(6)：802-807,6.DOI:10.11712/jms.2096-5532.2023.59.199
重度活动性狼疮性肾炎冲击治疗淋巴细胞亚群及血细胞比值变化
CHANGES OF LYMPHOCYTE SUBSETS AND BLOOD CELL RATIOS IN PATIENTS WITH SEVERE ACTIVE LUPUS NEPHRITIS AFTER STRESS-DOSED GLUCOCORTICOID TREATMENT
摘要
Abstract
Objective To investigate the changes in lymphocyte subpopulations and blood cell ratios in patients with se-vere active lupus nephritis(LN)before and after stress dosing of glucocorticoids.Methods Seventeen patients with severe active LN were given standardized stress dosing of prednisolone after excluding infection or receiving sufficient anti-infection treatment.The patients were monitored for lymphocyte subsets and blood cell ratios before and after high-dose prednisolone therapy to analyze the changes of lymphocyte subsets and blood cell ratios as well as the relationship between these parameters and clinical events.Results After prednisolone treatment,blood CD4+ T lymphocyte count,natural killer cells(NK)percentage,and helper/inducer T cell percentage were significantly increased,while B cell percentage,suppressor/cytotoxic T cell percentage,neutrophil/lympho-cyte ratio(NLR),and platelet/lymphocyte ratio(PLR)were significantly decreased(Z=-3.25 to 2.08,P<0.05).The propor-tion of activated T cells was significantly higher in patients with LN with infection than in those without infection at admission(Z=-2.27,P<0.05).After prednisolone therapy,the infection group showed a significantly higher activated T cell percentage,a sig-nificantly lower CD4+ T lymphocyte count,and a significantly lower helper/inducer T cell percentage compared with non-infection group(Z=-2.30 to-1.97,P<0.05).When using lymphocyte subsets to predict infection after prednisolone therapy,blood CD4+ T lymphocyte count had the highest area under the receiver operator characteristic curve,with a cut-off value of 253.50×106/L,sensitivity of 85.70%,and specificity of 83.30%.Conclusion There were changes in blood CD4+ T lymphocyte count,the percentages of NK cells,B cells,and suppressor/cytotoxic T cells,NLR,and PLR in patients with LN after stress-dosed glu-cocorticoid treatment.Blood CD4+ T lymphocyte count shows moderate predictive value for infection in LN.关键词
淋巴细胞亚群/红斑狼疮,系统性/狼疮肾炎/感染Key words
lymphocyte subsets/lupus erythematosus,systemic/lupus nephritis/infections分类
医药卫生引用本文复制引用
张丽君,李远,田芬,邢广群..重度活动性狼疮性肾炎冲击治疗淋巴细胞亚群及血细胞比值变化[J].青岛大学学报（医学版）,2023,59(6):802-807,6.基金项目
国家自然科学基金面上项目(81770699) （81770699）
