CD4^＋T淋巴细胞计数在ANCA相关性血管炎患者治疗过程中的变化及其意义

The Significance of CD4^＋T Lymphocyte Count during the Treatment of Patients with ANCA-Associated Vasculitis

摘要: 目的：探讨CD4^＋T淋巴细胞计数在ANCA相关性血管炎患者治疗过程中的变化及其意义。方法：选择青岛大学附属医院2019年1月1日~2020年8月1日在肾内科初诊为AAV的患者35例，检测患者活动期和缓解期CD4^＋T淋巴细胞计数、白细胞计数、淋巴细胞计数、中性粒细胞计数、C反应蛋白(CRP)、白蛋白(ALB)、估算的肾小球滤过率(eGFR)、血肌酐(Scr)、BVAS评分及红细胞沉降率(ESR)的变化，并分析BVAS评分与CD4+T淋巴细胞计数之间的关系。结果：缓解期患者BVAS评分、白细胞计数、中性粒细胞计数、ALB、CRP、ESR均显著下降，而CD4^＋T淋巴细胞、ALB治疗后均显著升高，而淋巴细胞计数、Scr、eGFR比较差异均无统计学意义(P > 0.05)。Spearman相关性分析显示，活动期时患者BVAS评分与CD4^＋T淋巴细胞计数呈显著负相关关系(r = −0.398, P < 0.05)。结论：AAV患者治疗不同时期CD4⁺T淋巴细胞计数有明显的变化，监测血清中CD4⁺T淋巴细胞计数可以指导AAV患者的临床治疗。

Abstract: Objective: To investigate the changes and significance of CD4^＋T lymphocyte count during the treatment of patients with ANCA-related vasculitis. Methods: Thirty-five patients who were newly diagnosed with AAV in the Department of Nephrology from Qingdao University Hospital from January 1, 2019 to August 1, 2020 were selected to detect CD4⁺T lymphocyte counts, white blood cell counts, lymphocyte counts, medium Changes in neutrophil count, C-reactive protein (CRP), albumin (ALB), estimated glomerular filtration rate (eGFR), blood creatinine (Scr), BVAS score and erythrocyte sedimentation rate (ESR), and analyzed the relationship between BVAS score and CD4⁺T lymphocyte count. Results: BVAS score, white blood cell count, neutrophil count, ALB, CRP, and ESR of patients in remission stage decreased significantly, while CD4^＋T lymphocytes and ALB increased significantly after treatment, but there was no difference in lymphocyte count, Scr, eGFR Statistical significance (P > 0.05). Spearman correlation analysis showed that there was a significant negative correlation between the BVAS score and CD4⁺T lymphocyte count of patients in the active phase (r = −0.398, P < 0.05). Conclusion: The CD4⁺T lymphocyte counts of AAV patients have significant changes in different periods of treatment. Monitoring the serum CD4+T lymphocyte counts can guide the clinical treatment of AAV patients.