论文部分内容阅读
目的:探讨淋巴细胞亚群以及单核细胞HLA-DR阳性率的表达对系统性红斑狼疮(systemic lupus erythematosus,SLE)合并感染与非感染患者之间诊断价值。方法 :收集2013年11月至2015年12月在东莞市第五人民医院肾病风湿免疫科诊治的SLE患者138例,依据SLE疾病活动指数(SLEDAI)及临床感染证据等分为3组,其中活动合并感染患者(活动+感染组)38例,SLE病情活动患者(活动组)47例,SLE病情稳定患者(稳定组)53例。采用流式细胞法对各组外周血Th细胞、Ts细胞、B细胞和NK细胞百分比以及单核细胞HLA-DR阳性表达率。结果:与活动组相比较,活动+感染组外周血Th细胞、NK细胞和单核细胞HLA-DR阳性表达率显著降低,Ts细胞、B细胞显著升高(P<0.05)。与稳定组相比,活动+感染组、活动组外周血Th细胞和NK细胞以及补体均显著降低,Ts细胞和B细胞均显著升高(P<0.05)。但活动组与稳定组相比,单核细胞HLA-DR阳性表达率差异无统计学意义(P>0.05)。各检测指标均与SLEDAI评分具有相关性(P<0.05)。结论:淋巴细胞亚群和单核细胞HLA-DR阳性率表达的检测不但能提示SLE活动情况,还能有助于鉴别是否合并感染。
Objective: To investigate the diagnostic value of the expression of HLA-DR positive rate of lymphocyte subsets and monocytes in patients with systemic lupus erythematosus (SLE) infection and non-infection. Methods: A total of 138 SLE patients were enrolled in the Department of Nephrology and Rheumatology, the Fifth People’s Hospital of Dongguan City, from November 2013 to December 2015. The patients were divided into 3 groups according to SLE disease activity index (SLEDAI) and clinical evidence of infection. Among them, There were 38 patients with infection (active + infection), 47 patients with active SLE (active) and 53 patients with stable SLE (stable). The percentage of Th cells, Ts cells, B cells and NK cells in peripheral blood and HLA-DR positive rate of monocytes were determined by flow cytometry. Results: Compared with the active group, the positive rate of HLA-DR of Th cells, NK cells and monocytes in active + infected group was significantly decreased, and the Ts cells and B cells were significantly increased (P <0.05). Compared with the stable group, the levels of Th cells, NK cells and complement in the active + infected group and active group were significantly decreased, and the Ts cells and B cells were significantly increased (P <0.05). However, there was no significant difference in HLA-DR positive rate of monocytes between active group and stable group (P> 0.05). Each test index was correlated with SLEDAI score (P <0.05). Conclusion: The detection of the positive rate of HLA-DR in lymphocyte subsets and monocytes not only can indicate the activity of SLE, but also help to identify whether the infection is complicated or not.