摘要
目的分析CD4+CD69+T细胞在自身免疫性溶血性贫血患者外周血中的表达及临床意义。方法采取前瞻性对照研究,选择我院自2018年3月至2021年3月新诊断的206例自身免疫性溶血性贫血病例作为观察组,另选同期的206例健康体检者病例作为对照组。检测外周血CD4+CD69+T细胞、CD4+T细胞CD69 mRNA及血浆CD69水平,使用Pearson相关性分析CD4+CD69+T细胞水平与血红蛋白浓度(Hb)、网织红细胞比值(Ret)、总胆红素(TBIL)、间接胆红素(IBIL)的关系,观察静脉血栓栓塞症发生情况,以受试者工作特征曲线(ROC)下面积(AUC)评价外周血CD4+CD69+T细胞表达水平对静脉血栓栓塞症的预测效能。结果观察组外周血CD4+CD69+T细胞、CD4+T细胞CD69 mRNA及血浆CD69水平均明显高于对照组,差异均有统计学意义(P<0.05);在观察组206例患者,溶血发作组外周血CD4+CD69+T细胞、CD4+T细胞CD69 mRNA及血浆CD69水平均明显高于病情缓解组,差异均有统计学意义(P<0.05);溶血发作组Hb明显低于病情缓解组,Ret、TBIL、IBIL水平均明显高于病情缓解组,差异均有统计学意义(P<0.05);经Pearson相关性分析,自身免疫性溶血性贫血患者外周血CD4+CD69+T细胞水平与Hb呈负相关(P<0.05),与Ret、TBIL、IBIL呈正相关(P<0.05);经ROC曲线分析,外周血CD4+CD69+T细胞表达水平预测自身免疫性溶血性贫血患者并发静脉血栓栓塞症的AUC为0.915(SE:0.068,OR:0.002,95%CI:0.000-1.000)。结论自身免疫性溶血性贫血患者外周血CD4+CD69+T细胞表达水平上调,其水平与病情演变密切相关,预测静脉血栓栓塞症的效能较好,值得临床予以重视。
Objective To analyze the expression and clinical significance of CD4+CD69+T cells in peripheral blood of patients with autoimmune hemolytic anemia.Methods A total of 206 cases of autoimmune hemolytic anemia admitted to our hospital from March 2018 to March 2021 were selected as the observation group,and 206 cases,who came for healthy physical examination during the same period,were selected as the control group.The levels of CD4+CD69+T cells in peripheral blood,CD69 mRNA in CD4+T cells and CD69 in plasma were detected.The relationship between CD4+CD69+T cell level and Hb,reticulocyte ratio(Ret),total bilirubin(TBIL)and indirect bilirubin(IBIL)was analyzed by Pearson correlation analysis to observe the occurrence of venous thromboembolism.The AUC of receiver operating characteristic was used to evaluate the predictive efficacy of CD4+CD69+T cell expression in peripheral blood for venous thromboembolism.Results The levels of CD4+CD69+T cells in peripheral blood,CD69 mRNA in CD4+T cells and CD69 in plasma of observation group were significantly higher than those of control group(P<0.05).Among 206 patients in the observation group,the levels of CD4+CD69+T cells in peripheral blood,CD69 mRNA in CD4+T cells and plasma CD69 in hemolytic attack group were significantly higher than those in remission group,with statistical significance(P<0.05).The Hb in hemolytic attack group was significantly lower while Ret,TBIL and IBIL levels were significantly higher than those in remission group,with statistical significance(P<0.05).Pearson correlation analysis showed that the levels of CD4+CD69+T cells in peripheral blood of patients with autoimmune hemolytic anemia were negatively correlated with Hb(P<0.05)while positively correlated with Ret,TBIL and IBIL(P<0.05).According to ROC curve analysis,the expression level of CD4+CD69+T cells in peripheral blood predicted that the AUC of patients with autoimmune hemolytic anemia complicated with venous thromboembolism was 0.915(SE:0.068,OR:0.002,95%CI:0.000-1.000).Conclusion The up-regulated expression level of CD4+CD69+T cells in peripheral blood of patients with autoimmune hemolytic anemia is closely related to disease evolution,and it has good efficacy in predicting venous thromboembolism and deserves clinical attention.
作者
董敏
沈观樵
DONG Min;SHEN Guanqiao(Shaoxing Second Hospital,Shaoxing 312000,China)
出处
《中国输血杂志》
CAS
2022年第3期265-269,共5页
Chinese Journal of Blood Transfusion
