Th17细胞在系统性红斑狼疮伴发心血管疾病中的意义探讨

目的：分析 Th17细胞在系统性红斑狼疮（systemic lupus erythematosus，SLE）并发心血管疾病（cardiovascular disease，CVD）中的意义。方法按照1997年美国风湿病协会修订的 SLE分类标准收集河北医科大学第二医院2011年9月～2013年3月住院的 SLE患者共61例，同时以性别年龄匹配的健康对照组20例作对照。SLE实验组分为 SLE并发CVD患者22例，SLE不并发CVD患者39例。采用流式细胞分析技术测定 Th17细胞，酶联免疫吸附法检测 IL-17，并分析与疾病活动的相关性。结果①SLE并发 CVD组、SLE不并发 CVD组和健康对照组 Th17细胞的检测结果分别为（2.09±0.98）％，（1.75±0.75）％和（0.89±0.44）％，健康对照组与 SLE并发 CVD组、SLE不并发 CVD组相比，差异有统计学意义（t＝4.717～5.030，P值均＜0.001）；IL-17在 SLE并发 CVD组、SLE不并发 CVD组和健康对照组的水平分别为85.64±20.76 pg／ml，75.25±28.14 pg／ml和35.06±6.58 pg／ml，健康对照组与 SLE并发 CVD组和 SLE不并发CVD组相比，差异有统计学意义（t＝6.275～9.954，P 值均＜0.001）；两组 SLE之间 Th17细胞和 IL-17水平差异无统计学意义（t＝1.520，1.513，P＞0.05）。②SLE患者血浆 IL-17水平与 SLEDAI积分和抗 ds-DNA抗体滴度之间呈正相关（r＝0.393，P＝0.008；r＝0.558，P＜0.001），与补体 C3水平呈负相关性（r＝－0.423，P＝0.005）。SLE患者中 Th17细胞在CD4＋T细胞中所占的比例与 SLEDAI评分和抗 ds-DNA抗体滴度之间呈正相关（r＝0.681.P＜0.001；r＝0.492，P＝0.015），而与C3水平呈负相关（r＝－0.534，P＝0.027）。结论 Th17细胞和 IL-17在 SLE中表达均升高，且与疾病活动性相关。心血管因素并未影响 SLE患者中Th17细胞和 IL-17的表达水平。

Evaluate the Significance of Th1 7 Cells in Systemic Lupus Erythematosus with Cardiovascular Disease

Objective To explore the role of Th17 cells in systemic lupus erythematosus （SLE）with cardiovascular disease （CVD）.Methods 61 patients of SLE were collected from September 2011 to March 2013 in the Second Hospital of Hebei Medical University by revised SLE classification standards of ACR in 1997.These patients were divided two groups：22patients of SLE with CVD and 39 patients of SLE without CVD;the control group include 20 healthy.Th17 cells were measured by flow cytometry,IL-1 7 was detected by enzyme-linked immunosorbent assay.The correlation among them and the disease active index were analyzed.Results ①The percent of Th1 7 cells in the group of SLE with CVD,that in the group of SLE without CVD and that in control group were （2.09±0.98）%,（1.75±0.75）% and （0.89±0.44）%,respec-tively.The percent of Th1 7 cells in healthy group were lower than that in SLE with CVD and SLE without CVD group （t=4.717～5.030,P〈0.001）.The level of IL-17 in the group of SLE with CVD,that in the group of SLE without CVD and that in control group were 85.64±20.76 pg/ml,75.25±28.14 pg/ml and 35.06±6.58 pg/ml respectively,and the serum of IL-17 in healthy group were lower than in SLE with CVD and SLE without CVD group （t=6.275～9.954,P〈0.001）. There were no significant difference of Th1 7 cells and IL-1 7 between SLE with CVD and SLE without CVD groups （t=1.520,P〉0.05;t=1.513,P〉0.05）.②The level of IL-17 were correlated positively with SLEDAI and the anti-double strand DNA （r=0.393,P=0.008;r=0.558,P〈0.001）,were correlated negatively with complement C3 （r=-0.423,P=0.005）.The percent of Th17 cells in CD4＋T cells were correlated positively with SLEDAIand the anti-double strand DNA （r=0.681,P〈0.001;r=0.492,P=0.015）were correlated negatively with complement C3 （r=-0.534,P=0.027）.Con-clusion The level of Th1 7 cells and IL-1 7 were high in SLE,and they were related with the disease activity.The cardiovas-cular factor had not affect the expression of Th1 7 cells and IL-1 7