肾间质淋巴细胞在狼疮性肾炎中的作用

目的：研究狼疮性肾炎（lupus nephritis,LN）患者肾间质淋巴细胞数量及分布特点,探讨其与外周血淋巴细胞亚群及临床病理指标间的相关性.方法：选取LN患者70例,应用免疫组化方法检测肾组织CD3、CD20、CD4及CD8浸润数量、分布特点,同时应用流式细胞术分析血液中相应淋巴细胞分布.结果：LN患者肾间质淋巴细胞以CD＋8T细胞浸润为主,与外周血淋巴细胞各亚群分布类似.肾间质各淋巴细胞亚群数量与血肌酐及GFR差异有统计学意义（P〈0.05）;Ⅳ型LN患者总T细胞及CD＋8T细胞浸润数量显著高于Ⅲ型LN患者（P〈0.05）,且各类淋巴细胞浸润数量与AI及CI存在一定相关性.结论：肾间质淋巴细胞亚群以T细胞及CD＋8T细胞为主,且与外周血淋巴细胞分布呈一定相关性.CD＋8T细胞在重症LN患者中发挥了强大的细胞毒性作用,加重了LN的进展.

The Contribution of Lymphocytes in Renal Tissue of Lupus Nephropathy

Objective：To investigate interstitial lymphocyte subsets infiltration and its correlation with peripheral blood lymphocytes and histopathological changes of lupus nephropathy （ LN ）. Methods： 70 biopsy - proven LN patients were selected in this study. Interstitial lymphocytes were detected by immunohistochemistry and peripheral blood lymphocytes were detected by flow cytome- ter. Results ： CDs T cells formed a prominent part of interstitial infiltrating cells in kidney and pheripheral blood in LN. The number of T, B cells and subtypes （ CD4＋ and CDs cells） were highly correlated to serum Cr and GFR （ P 〈0.05 ）. The number of T cells and CDs＋ T cells were much higher in IV LN than m LN （ P 〈 0.05 ）. Some lymphocytes were well correlated with AI and CI （ P 〈 0.05 ）. Conclusion ：Our findings show T cells and CDs＋ T cells are prominent cell subsets in renal tissues and correlated with pheripheral blood lymphocytes. CDs＋ T cells are cytotoxicity and seem to be important factor in severe and chronic LN, which aggravate LN proession.