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系统性红斑狼疮患者免疫指标变化及与狼疮性肾炎的关系OA

Changes of immune indicators in patients with systemic lupus erythematosus and their correlation with lupus nephritis

中文摘要英文摘要

目的 分析系统性红斑狼疮(systemic lupus erythematosus,SLE)患者外周血免疫指标变化,并探讨其与狼疮性肾炎(lupus nephritis,LN)的相关性.方法 回顾性选取 2021 年 11 月至 2023 年 10 月于宁波大学附属李惠利医院就诊的109 例SLE患者纳入SLE组,根据是否诊断为LN将SLE组患者分为LN组(56 例)和非LN组(53 例),选取同期在医院体检的健康者 32 人纳入健康对照组.检测研究对象的免疫指标,收集患者的临床资料及系统性红斑狼疮疾病活动指数 2000(systemic lupus erythematosus disease activity index 2000,SLEDAI-2000)评分.采用Spearman相关法分析SLE患者SLEDAI-2000 评分与免疫指标的相关性;采用多因素Logistic回归分析SLE患者发生LN的影响因素.结果 SLE组患者的总淋巴细胞计数、T细胞计数、自然杀伤细胞(natural killer cell,NK细胞)计数、B细胞计数、辅助性T细胞(helper T cell,Th细胞)比例、NK细胞比例、B细胞比例、免疫球蛋白(immunoglobulin,Ig)M、补体C3、补体C4均显著低于健康对照组(P<0.05),T细胞比例、抑制性T细胞(suppressor T cell,Ts细胞)比例、抗双链DNA抗体IgG均显著高于健康对照组(P<0.05).SLE组患者的SLEDAI-2000 评分与NK细胞计数、B细胞计数、NK细胞比例均呈负相关(P<0.05),与T细胞比例、Ts细胞比例均呈正相关(P<0.05).LN组患者的NK细胞计数、B细胞计数、NK细胞比例、B细胞比例均显著低于非LN组(P<0.05),T细胞比例、抗双链DNA抗体IgG、SLEDAI-2000 评分均显著高于非LN组(P<0.05).多因素Logistic回归分析结果显示,NK细胞计数、SLEDAI-2000 评分均是SLE患者发展为LN的影响因素(P<0.05).结论 免疫指标具备评估SLE患者疾病状态的能力,NK细胞计数下降、SLEDAI-2000 评分升高的SLE患者更容易发展为LN.

Objective To analyze the changes of immune indicators in patients with systemic lupus erythematosus(SLE)and explore their correlation with lupus nephritis(LN).Methods A total of 109 SLE patients treated in Affiliated Lihuili Hospital of Ningbo University from November 2021 to October 2023 were retrospectively included in SLE group,SLE patients were divided into LN group(56 cases)and non-LN group(53 cases)according to whether they were diagnosed with LN or not.32 healthy people who underwent physical examination in the hospital during the same period were included in healthy control group.The immune indicators of subjects were detected,and the clinical data and the scores of systemic lupus erythematosus disease activity index 2000(SLEDAI-2000)were collected.Spearman correlation method was used to analyze correlation between SLEDAI-2000 scores and immune indicators in SLE patients.Multivariate Logistic regression was used to analyze the influencing factors of LN in SLE patients.Results The total lymphocyte count,T cell count,natural killer(NK)cell count,B cell count,helper T(Th)cell proportion,NK cell proportion,B cell proportion,immunoglobulin(Ig)M,complement C3 and complement C4 in SLE group were significantly lower than those in healthy control group(P<0.05),T cell proportion,suppressor T(Ts)cell proportion and anti-double-stranded DNA antibody IgG were significantly higher than those in healthy control group(P<0.05).SLEDAI-2000 scores in SLE group were negatively correlated with NK cell count,B cell count and NK cell proportion(P<0.05),and were positively correlated with T cell proportion and Ts cell proportion(P<0.05).The NK cell count,B cell count,NK cell proportion and B cell proportion in LN group were significantly lower than those in non-LN group(P<0.05),T cell proportion,anti-double-stranded DNA antibody IgG and SLEDAI-2000 scores were significantly higher than those in non-LN group(P<0.05).Multivariate Logistic regression analysis showed that NK cell count and SLEDAI-2000 scores were all factors influencing the development of LN in SLE patients(P<0.05).Conclusion Immune indicators have the ability to evaluate the disease status of SLE patients.SLE patients with decreased NK cell count and increased SLEDAI-2000 scores are more likely to develop LN.

张日伊;穆银玉;邹松炎;谢服役

宁波大学附属李惠利医院检验科,浙江宁波 315046

临床医学

系统性红斑狼疮免疫指标狼疮性肾炎影响因素相关性

Systemic lupus erythematosusImmune indicatorLupus nephritisInfluence factorCorrelation

《中国现代医生》 2024 (022)

41-45 / 5

10.3969/j.issn.1673-9701.2024.22.010

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