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目的:探讨B淋巴细胞活化及凋亡、BlyS、IL-10、IL-6对狼疮性肾炎的(LN)影响。方法:以双抗体夹心酶联免疫吸附(ELISA)法测定LN患者外周血中BlyS水平,流式蛋白分析系统(CBA)测定外周血IL-6、IL-10水平,流式细胞仪测定外周血CD19+CD69+及CD19+凋亡率(AV)水平。结果:(1)①活动期和静止期LN患者CD19+CD69+、AV水平较正常组显著升高(P<0.01);②活动期LN患者IL-10、IL-6、CD19+CD69+、AV水平较静止期显著升高(P<0.01);③活动期、静止期BlyS水平较正常组差异无统计学意义(P>0.05)。(2)LN患者活动指数(SLEDAI)与ds-DNA、IL-10、AV之间呈正相关,与BlyS、CD19+CD69+水平无相关性;BlyS与ds-DNA、IL-10、CD19+CD69+、AV均无相关性;IL-10与ds-DNA、AV呈正相关,与CD19+CD69+无相关性。(3)逐步回归分析发现活动指数与C3、凋亡率、CD69、C4有相关性,C4对活动指数影响最大;凋亡率与IL-6、IL-10有相关性,IL-6对凋亡率的影响最大。结论:(1)活动期和静止期LN患者B淋巴细胞活化率及凋亡率均增多;(2)CD19+CD69+、CD19+凋亡率、IL-6、IL-10可反映狼疮的活动性。
Objective: To investigate the effect of B lymphocyte activation and apoptosis, BlyS, IL-10 and IL-6 on LN in patients with lupus nephritis. Methods: The levels of BlyS in peripheral blood of patients with LN were measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The levels of IL-6 and IL-10 in peripheral blood were measured by flow cytometry (CBA) CD19 + CD69 + and CD19 + apoptotic rate (AV) levels. Results: (1) ①The levels of CD19 + CD69 + and AV in patients with LN during and after active phase were significantly higher than those in normal subjects (P <0.01); ② The levels of IL-10, IL-6, CD19 + CD69 + (P <0.01). (3) There was no significant difference in the level of BlyS between the active group and the quiescent group compared with the normal group (P> 0.05). (2) There was a positive correlation between LN patient’s activity index (SLEDAI) and ds-DNA, IL-10 and AV, but not with BlyS and CD19 + CD69 + AV had no correlation; IL-10 and ds-DNA, AV was positively correlated, and CD19 + CD69 + no correlation. (3) Stepwise regression analysis showed that activity index was correlated with C3, apoptotic rate, CD69, C4 and C4 had the greatest impact on activity index; apoptosis rate was correlated with IL-6, IL-10, IL- Mortality most affected. Conclusions: (1) The activation rate of B lymphocytes and the rate of apoptosis in active and quiescent LN patients are increased. (2) The apoptosis rates of CD19 + CD69 + and CD19 +, IL-6 and IL-10 can reflect the activity of lupus.