系统性红斑狼疮患者外周血中B淋巴细胞活化状况与疾病活动性的关系

目的探讨系统性红斑狼疮患者外周血中B淋巴细胞及其活化状况与疾病活动性的关系。方法应用流式细胞术检测活动期与稳定期系统性红斑狼疮患者外周血中CD19+、CD23+/CD19+及HLA-DR+/CD19+细胞的表达情况;同时应用免疫学方法检测血清中ds-DNA与ANA水平。结果活动期患者CD19+、CD23+/CD19+及HLA-DR+/CD19+细胞表达率均高于稳定期患者及正常对照组,差异均有显著性意义;稳定期患者CD23+/CD19+表达很低,而HLA-DR+/CD19+双阳性细胞表达率高于正常对照组,但差异无显著性意义;且CD23+/CD19+双阳性细胞表达率与病情积分、ds-DNA及ANA均成正相关(P<0.01),而HLA-DR+/CD19+双阳性细胞与三者无相关关系(P>0.05)。结论活动期与稳定期患者均存在B淋巴细胞的克隆性增生与异常活化,B细胞的异常活化是病情活动的直接原因,晚期B细胞的异常活化是系统性红斑狼疮患者难彻底治愈与病情反复的原因之一。

The study of the relations between B lymphocyte activation in peripheral of systemic lupus erythematosus patients and the activity of the disease

Objective To investigate correlations between B lymphocyte activation in peripheral blood of systemic lupus erythematosus(SLE) patients and the activity of SLE.Methods CD19 , CD23 /CD19 and the HLA-DR /CD19 in peripheral blood of SLE patients were detected with two-color fluorograph;The level of ds-DNA and ANA detected with the method of immunoassay.Results The cell expression rate of CD19 ,CD23 /CD19 and HLA-DR /CD19 in peripheral blood of SLE patients in active SLE patients were significantly higher than that in inactive SLE patients,as well as those in normal controls. The cell expression rate of CD23 /CD19 in inactive SLE patients was very low, while the cell expression rate of HLA-DR /CD19 in inactive SLE patients was higher but not significantly higher than those in that in normal controls. Moreover,the cell expression rate of CD23 /CD19 was positive correlations with cumulative mark of SLE conditions and the level of ds-DNA and ANA(P<0.01). On the contrary, the cell expression rate of HLA-DR /CD19 was not.Conclusion The clone proliferation and exceptionally activation lie in both active and inactive SLE patients,and the exceptionally activation is the direct reason of the activity of the disease. The exceptionally activation of later period B lymphocyte is one of the reasons that the thorough cure of the SLE patients is difficult and that the SLE condition is repeat.