CD4⁺ T淋巴细胞计数与狼疮肾炎疾病活动度的相关性研究

Correlation Analysis of CD4⁺ T Cell Count with Disease Activity in Patients with Lupus Nephritis

摘要: 目的：探讨不同疾病活动度的狼疮肾炎(Lupus nephritis, LN)患者血液CD4⁺ T细胞计数与LN患者疾病活动度的相关性。方法：收集2017年10月至2019年3月在青岛大学附属医院风湿免疫科169例狼疮肾炎(LN)患者临床资料，按照SLE活动指数(systemic lupus erythematosus disease activity index, SLEDAI)分为病情活动组(n = 77)和病情稳定组(n = 92)，对照组为同期确诊为SLE且病情稳定的非LN患者(n = 64)。对CD4⁺ T细胞计数与SLEDAI评分、实验室指标的相关性进行统计学分析。结果：病情活动组CD4⁺ T细胞计数平均值低于病情稳定组[(227.46 ± 104.34)和(348.91 ± 98.22) cells/μl, P < 0.01]；同时低于对照组[(378.88 ± 169.61) cells/μL, (P < 0.01)]。对照组、病情稳定组、病情活动组的CD4⁺ T细胞计数与SLEDAI评分呈负相关(r = −0.445, P = 0.038; r = −0.419, P = 0.022; r = −0.673, P = 0.001)，病情稳定组与病情活动组CD4⁺ T细胞计数与24小时蛋白尿定量负相关(r = −0.544, P = 0.041; r = −0.629, P = 0.032)。结论：高疾病活动度的LN患者CD4⁺ T细胞计数明显降低，并与24小时蛋白尿定量负相关，提示临床中可通过监测CD4⁺ T细胞计数的动态改变判断LN病情活动，指导LN的临床治疗。

Abstract: Objection: To analyze the changes of serum CD4⁺ T cell count in lupus nephritis (LN) patients with different disease activities, and to investigate the correlation between CD4⁺ T cell count and clinical manifestations, laboratory examination and disease activity. Methods: A total of 169 patients with LN were divided into active group (n = 77) and stable group (n = 92) according to SLEDAI score. The CD4⁺ T cell count and the correlation between CD4⁺ T cell count and SLEDAI score was analyzed among the three groups, as well as analyzed the correlation between the CD4⁺ T cell count and laboratory indexes. Results: 1) The average count of CD4⁺ T cell in active groups was significantly lower than stable group [(227.46 ± 104.34) vs (348.91 ± 98.22) cells/μl, P<0.01], and lower than that in control group [(378.88 ± 169.61) cells/μl, (P < 0.01)]; 2) The CD4⁺ T cell count of all the groups had significant negative correlation with SLEDAI score (r = −0.445, P = 0.038; r = −0.419, P = 0.022; r = −0.673, P = 0.001); 3) The CD4⁺ T cell count of active group and stable group had a significant negative correlation with 24 hours urinary protein excretion (r = −0.544, P = 0.041; r = −0.629, P = 0.032). Conclusion: The CD4⁺ T cell count in LN Patients with high disease activity was significantly decreased and negatively correlated with 24-hour albuminuria. Our study suggests that the disease activity of LN can be assessed by monitoring the change of CD4⁺ T cell count, thus benefit the clinical treatment of LN.