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目的:探讨人重组粒细胞-巨噬细胞集落刺激因子(GM-CSF)和GM-CSF抗体(GM-CSF Ab)水平在系统性红斑狼疮(SLE)发病中尤其是导致血液学损害发生的可能作用机制。方法:①用酶联免疫吸附法(ELISA)测定40例SLE(SLE组,按白细胞计数又分为白细胞减少组20例,白细胞正常组20例)、11例其他结缔组织病(病例对照组)及20例健康体检者(健康对照组)血清GM-CSF和GM-CSF Ab的水平;②按SLEDAI评分将SLE组分为活动期组16例,非活动期组24例,用ELISA测定两组血清GM-CSF和GM-CSF Ab的水平;③将SLE组治疗足10个月者12例用ELISA测定血清GM-CSF和GM-CSF Ab的水平进行治疗前后配对比较。④分析SLE组血清GM-CSF及GM-CSF Ab水平与临床指标(SLEDAI评分、血白细胞计数)的相关性。结果:①白细胞减少组血清GM-CSF及GM-CSF Ab水平高于白细胞正常组、病例对照组和正常对照组(P<0.05),白细胞正常组血清GM-CSF及GM-CSF Ab水平也高于疾病对照组和正常对照组(P<0.05);②活动期组血清GM-CSF及GM-CSF Ab水平高于非活动期组(P<0.05);③12例完成治疗的SLE患者治疗后血清GM-CSF及GM-CSF Ab水平低于治疗前(P<0.05);④SLE组血清GM-CSF及GM-CSF Ab水平与SLEDAI评分呈显著正相关(P<0.01),与SLE血白细胞计数呈显著负相关(P<0.05)。结论:血清GM-CSF及GM-CSF Ab水平与SLE,尤其与合并血液学损害的SLE患者疾病活动性有关,可能用来作为合并血液学损害的SLE患者的生物治疗靶点。
OBJECTIVE: To investigate the possibility that the levels of GM-CSF and GM-CSF Ab may play an important role in the pathogenesis of systemic lupus erythematosus (SLE) Mechanism. Methods: ①40 cases of SLE (SLE group) were divided into leukopenia group (n = 20) and leukocyte normal group (n = 20) according to leukocyte count, and other connective tissue diseases (case control group) by enzyme-linked immunosorbent assay And 20 healthy subjects (healthy control) serum GM-CSF and GM-CSF Ab levels; ② According to the SLEDAI score, the SLE group was divided into active group (16 cases) and inactive group (24 cases) Serum levels of GM-CSF and GM-CSF Ab; ③ SLE group treated for 10 months in 12 cases by ELISA serum GM-CSF and GM-CSF Ab levels were compared before and after treatment. ④ Analysis of serum SLE group GM-CSF and GM-CSF Ab levels and clinical indicators (SLEDAI score, white blood cell count) correlation. Results ① The levels of serum GM-CSF and GM-CSF Ab in leukopenia group were significantly higher than those in normal leukocyte group, control group and normal control group (P <0.05) (P <0.05). ② The levels of serum GM-CSF and GM-CSF Ab in the active group were higher than those in the inactive group (P <0.05); ③ The serum of the 12 patients with SLE after treatment (P <0.05) .④The levels of serum GM-CSF and GM-CSF Ab in SLE group were positively correlated with SLEDAI score (P <0.01), and the levels of SLE white blood cell count Significant negative correlation (P <0.05). CONCLUSIONS: Serum levels of GM-CSF and GM-CSF Ab are associated with SLE, especially with SLE patients with hematologic impairment, and may be used as biologic targets for SLE patients with hematologic compromise.