外周血T淋巴细胞CD69在狼疮性肾炎患者中的变化及意义

目的：探讨狼疮性肾炎（LN）患者外周血中T淋巴细胞CD69的变化及意义。方法：收集LN患者活动组35例、稳定组25例和健康对照组30例,采用流式细胞仪测定外周血中T淋巴细胞CD4.CD69、CD8.CD69浓度变化;利用酶联免疫吸附（ELISA）法测定血清可溶性细胞间黏附分子-1表达,并分析其与系统性红斑狼疮活动性指标的关系。结果：（1）活动组LN患者淋巴细胞表达CD4.CD69、CD8.CD69、sICAM-1均明显升高,与狼疮性肾炎稳定组比较,差异有统计学意义P均〈0.01;（2）LN患者血浆CD4.CD69与SLEDAI评分、sICAM-1、24 h尿蛋白呈正相关（P均〈0.01）,与补体C3、C4呈负相关（P均〈0.01）;（3）LN患者血浆CD8.CD69与SLEDAI评分、24 h尿蛋白呈正相关（P均〈0.01）,与补体C3呈负相关（P均〈0.01）、与C4亦呈负相关（P〈0.05）;（4）LN患者SLEDAI评分与补体C3、C4负相关（P均〈0.01）,与24 h尿蛋白定量呈正相关（P〈0.01）;（5）LN患者血清sICAM-1与SLEDAI评分正相关（P〈0.05）、与CD4.CD69、CD8.CD69、24 h尿蛋白定量正相关（P均〈0.01）、与24 h尿蛋白定量呈正相关（P〈0.05）与补体C3、C4负相关（P均〈0.01）。结论：LN患者体内存在T细胞CD69表达可早期反映LN的活动,sICAM-1可能参与CD69引起肾脏的内皮细胞损伤,测定外周血CD69、sICAM-1有助于判断LN的活动性,有可能成为判断LN早期活动指标之一。

The Change and Significance of CD_（69） in Peripheral Blood T Lymphocytes in Patients with Lupus Nephritis

Objective：Explore the change and significance of CD69in peripheral Blood T lymphocytes in patients with Lupus Nephritis.Methods：35 cases of patients with active LN group,stable LN group of 25 patients and the healthy control group of 30 patients,detecting the T lymphocytes CD4.CD69,CD8.CD69concentration in peripheral blood by flow cytometry;using the enzyme-linked immunosorbent assay（ELISA） method for measuring serum soluble intercellular adhesion molecule-1 expression and analysising its relationship with systemic lupus erythematosus activity index.Results：（1） The active LN patients groups lymphocyte expression of CD4.CD69,CD8.CD69,sICAM-1 were significantly higher,as compared with stable LN groups,there was significant（both P〈0.01）;（2） The plasma CD4.CD69of LN patients with SLEDAI score,sICAM-1,24-hour urine protein were positively correlated（all P〈0.01）,with complement C3,C4were negatively correlated（all P〈0.01）;（3） The plasma CD8.CD69of LN with SLEDAI score,24-hour urine protein were positively correlated（all P〈0.01）,with complement C3was negatively correlated（P 0.01）,with C4also negatively correlated（P〈0.05）;（4） SLEDAI score in LN patients with complement C3,C4were negatively correlated（P〈0.01）,with 24-hour urinary protein excretion was positively correlated（P〈0.01）;（5） The serum sICAM-1 was positively correlated with SLEDAI score（P〈0.05）,with CD4.CD69,CD8.CD69,24-hour urine protein were positive correlation（all P〈0.01）,with complement C3,C4was negatively correlated（P〈0.01）.Conclusion：The existence of early T-cell CD69expression may reflect the activity of LN,sICAM-1 may be involved in CD69induced renal endothelial cell injury,measured in peripheral blood CD69,sICAM-1 help determine the activity of LN,may become an early activity indicators in LN.