摘要
目的探讨系统性红斑狼疮(SLE)患者不同巨细胞病毒(CMV)感染状态淋巴细胞亚群的特征,为临床诊断系统性红斑狼疮提供依据。方法选取2016年6月至2019年6月于南京中医药大学附属张家港医院的SLE住院患者共96例,其中合并巨细胞病毒血症患者18例(巨细胞病毒血症组)、巨细胞病毒病患者50例(巨细胞病毒病组)和无CMV感染者28例(对照组)。获取3组患者的一般资料、常规实验室指标、CMV DNA拷贝数和外周血淋巴细胞亚群计数;并比较CMV感染者的上述指标,分析不同CMV感染状态下淋巴细胞亚群的特征。结果巨细胞病毒血症组患者和巨细胞病毒病组患者的红细胞沉降率(t=-0.141、P=0.025,t=-0.194、P=0.003)CRP水平显著高于对照组(t=-0.563、P=0.010),巨细胞病毒病组患者CRP(t=-0.854、P=0.006)、环磷酰胺治疗例数(χ^2=-6.139、P=0.013)、血CMV DNA拷贝数(t=-0.355、P=0.041)均显著高于巨细胞病毒血症组。巨细胞病毒血症组患者与对照组患者总淋巴细胞计数、CD3+T细胞、CD3+CD4+T细胞、CD3+CD8+T细胞、CD19+B细胞和CD56+CD16+NK细胞计数差异均无统计学意义(P均>0.05)。巨细胞病毒病患者总淋巴细胞计数(t=0.933、P<0.001)、CD3+T细胞(t=0.177、P=0.018)、CD3+CD4+T细胞(t=0.207、P<0.001)、CD3+CD8+T细胞(t=0.169、P<0.001)和CD19+B细胞(t=0.320、P=0.023)显著低于对照组患者。结论淋巴细胞计数减低(尤其是CD4+T细胞计数减低)常见于SLE患者伴发CMV感染中常见,是系统性红斑狼疮患者CMV感染诊断的潜在生物标记物。
Objective To investigate the characteristic of lymphoctye subsets of patients with systemic lupus erythematosus(SLE)in different status of cytomegalovirus(CMV)infection and to provide new basis for clinical diagnosis of SLE.Methods Total of 96 inpatients with SLE admitted to Zhangjiagang Hospital Affiliated to Nanjing University of Chinese Medicine from June 2016 to June 2019 were selected,including 18 patients with cytomegaloviremia(cytomegaloviremia group),50 patients with cytomegalovirus disease(cytomegalovirus disease group),and 28 patients without CMV infection(control group).General clinical data,routine laboratory indicators,CMV DNA copies and peripheral blood lymphocyte subsets of the three groups were analyzed,respectively.The above indicators were compared among patients with different CMV infection status,and the characteristics of lymphocyte subsets in different status of CMV infection were analyzed.Results The erythrocyte sedimentation rate(t=-0.141,P=0.025;t=-0.194,P=0.003)of cytomegaloviremia group and cytomegalovirus disease group were significantly higher than those of control group and CRP level of cytomegalovirus disease group was significantly higher than that of control group(t=-0.854,P=0.006).The cases treated with cyclophosphamide(χ^2=-6.139,P=0.013)and the copies of CMV DNA in blood(t=-0.355,P=0.041)in cytomegalovirus disease group were significantly higher than those of cytomegaloviremia group,all with significant differences.There were no significant differences in total lymphocyte count,CD3+T cells,CD3+CD4+T cells,CD3+CD8+T cells,CD19+B cells and CD56+CD16+NK cells between the cytomegaloviremia group and the control group(all P>0.05).Total lymphocyte count(t=0.933,P<0.001),CD3+T cells(t=0.177,P<0.001),CD3+CD4+T cells(t=0.207,P<0.001),CD3+CD8+T cells(t=0.169,P<0.001)and CD19+B cells(t=0.320,P=0.023)were significantly lower in patients with cytomegalovirus disease than those of control group.Conclusions Low lymphocyte count(especially CD4+T cell count)was common in patients with SLE complicated with CMV infection,which was a potential biomarker for the diagnosis of CMV infection in patients with SLE.
作者
王凛介
朱科达
刘风云
马佳星
陶丽红
张辰伟
Wang Linjie;Zhu Keda;Liu Fengyun;Ma Jiaxing;Tao Lihong;Zhang Chenwei(Department of Rheumatology and Immunology,Zhangjiagang Hospital,Nanjing University of Chinese Medicine,Zhangjiagang 215600,China;Department of Rheumatology and Immunology,Zhangjiagang First People’s Hospital,Zhangjiagang 215600,China)
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2020年第6期501-506,共6页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
江苏省卫生健康委2019年度医学科研立项项目(No.Z201954)。
