系统性红斑狼疮合并带状疱疹病毒感染的免疫抑制

目的探讨系统性红斑狼疮（SLE）合并带状疱疹（HZ）病毒感染的临床免疫特点及物理治疗安全性。方法回顾性分析10例合并HZ感染的SLE患者，与同期住院的无感染的SLE患者30例比较，观察两组的一般资料，发病前、发病时、治愈后的实验室指标及T淋巴细胞亚群计数。结果两组患者一般资料无差异；常规实验室检查指标比较：SLE合并HZ组发病前中性粒细胞绝对值升高、白细胞计数升高，发病时淋巴细胞百分比下降、C反应蛋白升高的比例差异有统计学意义（P<0.05）；T淋巴细胞亚群检查指标比较：SLE合并HZ组发病前CD3+百分率升高、CD16+CD56+百分率下降、4/8Ratio计数异常的比例差异有统计学意义（P<0.01），CD8+百分率升高、CD8+计数升高、CD16+CD56+计数下降的比例差异有统计学意义（P<0.05）；发病时CD3+百分率升高、CD8+百分率升高、CD4+百分率下降、4/8Ratio计数异常的比例差异有统计学意义（P<0.05），CD16+CD56+百分率下降、CD8+计数升高的比例差异有统计学意义（P<0.01）；治愈后CD16+CD56+百分率下降的比例差异有统计学意义（P<0.01）。HZ感染的治疗时间5±1.3 d，治愈率100%，无后遗神经痛发生。结论SLE合并HZ感染存在免疫抑制状态。提示我们在SLE治疗过程中应加强T淋巴细胞亚群的监测。抗病毒药物和物理治疗对SLE合并HZ感染的治疗安全、有效。

Analysis of immune suppression in patients with systemic lupus erythematosuscomplicated by herpes zoster virus infection

Objective To explore the changes in cellular immune function and the safety of physical therapy in patients withsystemic lupus erythematosus (SLE) complicated by herpes zoster (HZ) virus infection. Methods A retrospective analysis wasconducted among 10 SLE pateints with HZ virus infection, with 30 SLE patients without HZ infection as the control group.The results of routine laboratory tests and T lymphocyte subset counts (before and during infection and after cure of infection)were compared between the two groups. Results The proportion of patients with significantly increased absolute neutrophilcount and white blood cell count before HZ infection, and those with decreased lymphocyte percentage and elevatedC-reactive protein during infection differed significantly between the two groups (P<0.05). Before HZ infection, theproportions of patients with increased CD3+%, decreased CD16+CD56+%, abnormal 4/8 ratio (P<0.01) and those with increasedCD8+% and CD8+ count and decreased CD16+CD56+ count differed significantly between the two groups (P<0.05). During HZinfection, the proportion of patients with increased CD3+% and CD8+% and decreased CD4+% and 4/8 ratio count (P<0.05) andthose with decreased CD16+CD56+% and increased CD8+ count differed significantly between the two groups (P<0.01). Aftercure of HZ infection, the proportion of patients with decreased CD16 +CD56 +% was significantly different between the twogroups (P<0.01). The treatment time of HZ infection averaged 5 ± 1.3 days with a cure rate of 100%; postherpetic neuralgiaoccurred in none of the patients after the treatment. Conclusion Patients with SLE complicated by HZ infection are in animmunosuppressive state, suggesting the need of monitoring T lymphocyte subsets in SLE treatment. The combined use ofantiviral drugs and physical therapy can be safe and effective for treatment of SLE complicated by HZ infection.