论文部分内容阅读
目的探讨血管炎患者外周血白细胞 CD_(146)表达与临床活动性间的关系。方法流式细胞术检测39例活动期系统性血管炎患者[显微镜下多血管炎(MPA)13例,韦格纳肉芽肿(WG)9例,变应性肉芽肿性血管炎(CSS)2例,大动脉炎(TA)9例,白塞病(BD)4例,结节性多动脉炎(PAN)2例]及24例系统性红斑狼疮(SLE)患者外周血白细胞 CD_(146)表达,其中18例(MPA 5例,WG4例,CSS 2例,SLE 4例,PAN 2例,TA 1例)患者经糖皮质激素和环磷酰胺治疗后于病情好转时再次检测。结果 (1)与健康者相比,血管炎患者活动期中性粒细胞、淋巴细胞 CD_(146)表达增多,尤以中性粒细胞最多,差异均有统计学意义(P<0.05)。(2)中性粒细胞 CD_(146)表达与淋巴细胞、单核细胞CD_(146)表达相关(r 值分别为0.66、0.853,P=0.000),与病程、年龄、血沉、C 反应蛋白、抗中性粒细胞胞浆抗体(ANCA)、PR3-ANCA、MPO-ANCA、血肌酐、伯明翰血管炎活动指数(BVAS)、系统性红斑狼疮疾病活动指数(SLEDAI)等无明显相关(r 值分别为-0.108、-0.059、-0.073、-0.103、0.012、-0.5、-0.232、0.001、-0.08、0.089,P>0.5)。(3)18例患者经治疗后好转期中性粒细胞、淋巴细胞 CD_(146)表达多数呈逐渐减少的趋势(P<0.05)。结论 CD_(146)在血管炎患者活动期外周血白细胞尤其是中性粒细胞中表达明显升高,随着糖皮质激素和免疫抑制剂治疗病情好转后呈下降或转阴趋势,其在血管炎发病机制中的意义有待深入研究。
Objective To investigate the relationship between the expression of CD_ (146) and the clinical activity of leukocytes in patients with vasculitis. Methods Thirty-nine patients with active systemic vasculitis were examined by flow cytometry [13 cases of MPA under microscope, 9 cases of Wegener’s granulomatosis (WG), 2 cases of allergic granulomatous vasculitis (CSS) 2 9 cases of aorta (TA), 4 cases of Behcet’s disease (BD), 2 cases of polyarteritis nodosa (PAN) and 24 cases of systemic lupus erythematosus (SLE) 18 of them (MPA 5, WG 4, CSS 2, SLE 4, PAN 2, TA 1) were treated with glucocorticoid and cyclophosphamide and then tested again when the condition improved. Results (1) Compared with healthy controls, the expression of CD_ (146) in neutrophils and lymphocytes in vasculitis patients was increased, especially in neutrophils, the difference was statistically significant (P <0.05). (2) CD_ (146) expression of neutrophils was correlated with CD_ (146) expression of lymphocytes and monocytes (r = 0.66,0.853, P = 0.000, respectively), but not with age, There was no significant correlation between anti-neutrophil cytoplasmic antibody (ANCA), PR3-ANCA, MPO-ANCA, serum creatinine, BVAS, SLEDAI -0.108, -0.059, -0.073, -0.103, 0.012, -0.5, -0.232, 0.001, -0.08, 0.089, P> 0.5). (3) The expression of CD_ (146) in neutrophils and lymphocytes in the 18 patients was gradually decreased after treatment (P <0.05). Conclusion The expression of CD_ (146) in peripheral leukocytes, especially neutrophils, in active stage of vasculitis patients is obviously increased. With the improvement of glucocorticoid and immunosuppressive agents, CD_ (146) The significance of the pathogenesis needs further study.