现代检验医学杂志2025，Vol.40Issue(4)：1-7,7.DOI:10.3969/j.issn.1671-7414.2025.04.001
系统性红斑狼疮患儿外周血EB病毒载量与T淋巴细胞亚群分布的关系及在肝损伤中的协同作用
Relationship between Epstein-barr Viral Load and T Lymphocyte Subsets Distribution in Peripheral Blood of Children with Systemic Lupus Erythematosus and Synergistic Effect in Liver Injury
摘要
Abstract
Objective To explore the relationship between epstein-barr viral(EBV)load and T lymphocyte subsets distribution in peripheral blood of children with systemic lupus erythematosus(SLE)and its synergistic effect on liver injury.Methods A total of 212 children with SLE admitted to the Xinjiang Uygur Autonomous Region Children's Hospital from October 2021 to September 2023 were selected as the study subjects.The SLE disease activity index(SLEDAI)score was divided into active group(n=58)and inactive group(n=154).The clinical data and laboratory indexes of the two groups were compared.The curve relationship between EBV load and T lymphocytes was analyzed by local weighted scatterplot smoothing(LOWESS)method.According to the occurrence of liver injury,212 children with SLE were divided into two groups(n=166)without liver injury and(n=46)with liver injury.The clinical data of the two groups were compared.Multifactor Logistics regression analysis was used to screen the influencing factors of liver injury in SLE children.Restricted cubic spline(RCS)model was used to analyze the relationship between EBV load,T lymphocytes and liver injury.The unconditioned Logistic regression model was used to analyze the interaction between EBV load and T lymphocytes on liver injury.Results Compared with the inactive group,the active group had younger age(t=9.265),higher hormone dosage(t=2.369),decreased ALB,CD4+,CD4+/CD8+levels(t=4.870,3.463,5.820),and increased EBV load,CD3+,CD8+levels(t=40.830,12.719,5.048),and the differences were statistically significant(all P<0.05).LOWESS analysis showed that EBV load had a nonlinear relationship with CD3+,CD4+,CD8+and CD4+/CD8+.The proportion of children with liver injury who had a disease course of≤3 months,EBV load,CD3+and CD8+levels,and the proportion of active children were lower than those without liver injury(t/χ2=10.749～30.378);the levels of ALB,CD4+and CD4+/CD8+indexes were higher than those without live injury(t=13.561,3.117,13.204),and the differences were statistically significantly(all P<0.05).Multivariate Logistic regression analysis showed that disease duration≤3 months,EBV load,CD3+,ALB,CD4+/CD8+and active SLE were influential factors for liver injury in SLE children(Wald χ2=1.020～1.932,all P<0.05).The results of RCS model analysis showed that EBV load,CD3+and CD8+were positively correlated with liver injury in SLE children,and CD4+,CD4+/CD8+were negatively correlated with liver injury in SLE children.Interaction analysis results showed that EBV load≥450 IU/ml had a multiplicative and additive interaction with CD3+≥60%,CD4+<30%,CD8+≥37%and CD4+/CD8+<0.94,and the risk of liver injury in SLE children was higher when the two factors co-existed.Conclusion There is a nonlinear relationship between EBV load in peripheral blood of SLE children and CD3+,CD4+,CD8+and CD4+/CD8+.Peripheral blood EBV load and abnormal expression of CD3+,CD4+,CD8+and CD4+/CD8+are all factors affecting liver injury in children with SLE,and there is a multiplicative and additive interaction between the above factors.关键词
系统性红斑狼疮/EB病毒/T淋巴细胞/肝损伤Key words
systemic lupus erythematosus/epstein-barr virus/T lymphocytes/liver injury分类
医药卫生引用本文复制引用
王倩,单新洁,安美玉..系统性红斑狼疮患儿外周血EB病毒载量与T淋巴细胞亚群分布的关系及在肝损伤中的协同作用[J].现代检验医学杂志,2025,40(4):1-7,7.基金项目
新疆维吾尔自治区自然科学基金(项目编号:2022D01B193). （项目编号:2022D01B193）
