系统性红斑狼疮患者外周血B细胞亚群的分布及临床应用
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四川省南充市市校科技战略合作项目(22SXQT0371);


Distribution of peripheral blood B cell subsets in patients with systemic lupus erythematosus and their clinical applications
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    摘要:

    目的:分析系统性红斑狼疮(SLE)患者外周B细胞亚群的分布及临床应用。方法:选取52例SLE患者(SLE组)、36名体检健康者(HC组)及30例类风湿关节炎(RA组)患者为研究对象。比较三组对象外周血B细胞各亚群细胞[B1细胞、滤泡性B细胞(FOB)、调节性B细胞(Breg)、年龄相关性B细胞(ABC)]占比;ROC曲线分析单个及多个B细胞亚群组合对SLE的诊断效能。同时收集SLE患者的SLE活动度评分(SLEDAI)、血沉(ESR)、C反应蛋白(CRP)、补体C3与C4、免疫球蛋白及多种自身抗体等临床资料,分析B细胞亚群占比与上述指标的相关性。结果:与HC组比较,SLE组B1、Breg和ABC细胞占比增高(P<0.05),FOB降低(P<0.05);与RA组比较,SLE组B1和Breg增高(P<0.05),FOB降低(P<0.05);RA组与HC组各亚群细胞占比比较,差异无统计学意义(P>0.05)。ROC曲线分析显示,各B细胞亚群均对SLE有一定诊断效能,多个亚群组合对SLE的诊断效能更高,11种组合方式诊断SLE的曲线下面积(AUC)为0.756~0.892(P<0.05),其中AUC最高的是ABC+B1+Breg+FOB组合。相关性分析显示,ABC亚群占比与ESR正相关(P<0.05,r=0.403);Breg与补体C3水平负相关(P<0.05,r=-0.421),与抗双链DNA抗体(ds-DNA)正相关(P<0.05,r=0.488),与线粒体2型抗体正相关(P<0.05,r=0.604),与SLEDAI正相关(P<0.05,r=0.353);ABC与FOB在SLE组中负相关(P<0.05,r=-0.571),而在HC及RA组中二者无相关性(P>0.05)。结论:SLE患者B细胞亚群分布与正常人群存在差异,单个或多个指标联合对SLE具有较好的诊断效能,且亚群分布与临床和实验室多种指标相关,提示可能具有疾病诊断和病情评估的价值。

    Abstract:

    Objective:To analyze the distribution of peripheral blood B cell subsets in patients with systemic lupus erythe-matosus(SLE)and their clinical applications.Methods:52 SLE patients(SLE group),36 healthy controls(HC group)and 30 rheumatoid arthritis(RA group)patients were included.The percentage of B1,FOB,Breg and ABC cells in total B cells was measured by Flow cytometry.Diagnostic efficacy of individual and combined B cell subsets for SLE was evaluated via ROC curves.Clinical data on SLE activity score(SLEDAI),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),com-plement C3 and C4,immunoglobulin,and various autoantibodies from SLE patients were collected,and the correlations between the subsets percentage and these indicators were analyzed.Results:Compared to HC group,the percentage of B1,Breg,and ABC were higher in SLE group(P<0.05)and the percentage of FOB was lower(P<0.05).The percentage of B1,and Breg in SLE group were obviosly higher than those in RA group(P<0.05)and FOB was lower(P<0.05).There was no statistically sig-nificant difference in the proportion of cells in each subgroup between the RA group and the HC group(P>0.05).ROC curve analysis showed that all B cell subgroups had a certain diagnostic efficacy for SLE,and the combination of multiple subgroups had a higher diagnostic efficacy for SLE.The area under the curve(AUC)of 11 combinations for diagnosing SLE was 0.756~0.892(P<0.05),with(ABC+B1+Breg+FOB)combined was highest.Results of Assay of correlations showed that the per-centage of ABC cells positively correlated with the level of ESR(P<0.05,r=0.403).The percentage of Breg cells negatively correlated with the level of C3(P<0.05,r=-0.421)and positively correlated with the level of anti-dsDNA(P<0.05,r=0.488),anti-M2(P<0.05,r=0.604),SLEDAI(P<0.05,r=0.353).ABC and FOB were negatively correlated in the SLE group(P<0.05,r=-0.571),while there was no correlation between the two in the HC and RA groups(P>0.05).Conclu-sion:There are differences in the distribution of B cell subsets between SLE patients and the normal population.The combina-tion of single or multiple indicators has good diagnostic efficacy for SLE,and the distribution of subsets is correlated with multi-ple clinical and laboratory indicators,suggesting that it may have value in disease diagnosis and disease assessment.

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陈小艳;邢艳;.系统性红斑狼疮患者外周血B细胞亚群的分布及临床应用[J].川北医学院学报,2025,40(10):1285-1290.

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  • 在线发布日期: 2025-11-03
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