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目的观察活动期系统性红斑狼疮(SLE)患者外周血淋巴细胞(PBL)凋亡状态及Fas、FasL的表达,探讨地塞米松(Dex)对其的影响。方法分离19例SLE患者及10例健康人PBL,植物血凝素(PHA)刺激培养72h,流式细胞仪检测其凋亡率及Fas、FasL的表达。SLE患者的PBL,再经Dex作用后检测上述指标。结果SLE患者PBL在PHA刺激培养72h后凋亡率(42.81±7.52)%,较健康对照组(4.74±0.59)%明显升高(P<0.01),Fas表达SLE组(47.67±4.80)MFI,较健康对照组(21.70±5.16)MFI增高(P<0.01),FasL表达阳性细胞百分率与健康对照无明显差别(2.48±0.24)%,(2.64±0.31)%(P>0.05);SLE患者PBL经Dex培养后凋亡率(63.92±7.58)%较未处理组增高;Fas表达、FasL阳性细胞百分率两组间差异无统计学意义。结论SLE患者存在PBL凋亡及Fas、FasL表达的异常;Dex可加速SLE患者PBL的凋亡,且可能是通过Fas/FasL以外的途径实现。
Objective To observe the apoptotic status of peripheral blood lymphocytes (PBL) and the expression of Fas and FasL in patients with active systemic lupus erythematosus (SLE) and explore the effect of dexamethasone (Dex) on them. Methods Twenty-nine patients with SLE and 10 healthy people were isolated and stimulated with phytohemagglutinin (PHA) for 72 hours. The apoptosis rate and the expression of Fas and FasL were detected by flow cytometry. PBL in patients with SLE, after Dex test the above indicators. Results The apoptosis rate of PBL in SLE patients after PHA stimulation for 72 h was 42.81 ± 7.52%, which was significantly higher than that in healthy controls (4.74 ± 0.59%) (P <0.01), and the Fas expression was 47.67 ± 4.80 (MFI) Compared with the healthy controls, the MFI of the FasL positive cells was significantly higher than that of the healthy controls (2.70 ± 5.16 vs 2.70 ± 5.16, P <0.01). The percentage of FasL positive cells was 2.48 ± 0.24% (2.64 ± 0.31)% (P> 0.05) The apoptosis rate after Dex culture (63.92 ± 7.58)% was higher than that of the untreated group. There was no significant difference between the two groups in the expression of Fas and the percentage of FasL positive cells. Conclusions The apoptosis of PBL and the expression of Fas and FasL in SLE patients are abnormal. Dex can accelerate the apoptosis of PBL in patients with SLE and may be achieved by other routes than Fas / FasL.