【摘要】：目的探討程序性死亡配體1(PD-L1)在系統(tǒng)性紅斑狼瘡(SLE)患者外周血中性粒細(xì)胞上的表達(dá)及臨床意義。方法應(yīng)用流式細(xì)胞儀檢測(cè)77例SLE患者和43例健康對(duì)照者外周血中性粒細(xì)胞表面PD-L1表達(dá)百分率,比較SLE組和對(duì)照組之間以及SLE活動(dòng)組和穩(wěn)定組中性粒細(xì)胞表面PD-L1表達(dá)百分率,分析其與SLE臨床表現(xiàn)及實(shí)驗(yàn)室檢查指標(biāo)的相關(guān)性,并檢測(cè)10例SLE患者治療前后中性粒細(xì)胞PD-L1的表達(dá)。結(jié)果① SLE組外周血PD-L1+中性粒細(xì)胞百分率高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.000 1);活動(dòng)組PD-L1+中性粒細(xì)胞百分率高于穩(wěn)定組,差異有統(tǒng)計(jì)學(xué)意義(P=0.002 7)。② SLE患者PD-L1+中性粒細(xì)胞百分率與SLE疾病活動(dòng)性評(píng)分(SLEDAI)、抗核抗體(ANA)、免疫球蛋白G(IgG)、紅細(xì)胞沉降率(ESR)呈正相關(guān)性,與紅細(xì)胞計(jì)數(shù)(RBC)、血紅蛋白(HGB)濃度、紅細(xì)胞壓積(HCT)呈負(fù)相關(guān)性,對(duì)這些呈線性相關(guān)的變量進(jìn)行線性回歸分析顯示SLE患者PD-L1+中性粒細(xì)胞百分率與ANA和ESR的線性回歸差異有統(tǒng)計(jì)學(xué)意義(P=0.020、0.005)。以外,在低補(bǔ)體3(C3)組和低白細(xì)胞計(jì)數(shù)(WBC)組中,SLE患者PD-L1+中性粒細(xì)胞百分率與C3、WBC呈負(fù)相關(guān)性。SLE患者中低WBC、低血小板計(jì)數(shù)(PLT)、高中性粒細(xì)胞數(shù)、高中性粒細(xì)胞百分比陽(yáng)性組PD-L1+中性粒細(xì)胞百分率均高于對(duì)應(yīng)的陰性組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。③ SLE患者發(fā)熱、皮膚表現(xiàn)、低白細(xì)胞血癥、低紅細(xì)胞血癥、低血小板血癥、貧血和血尿陽(yáng)性組PD-L1+中性粒細(xì)胞百分率均高于對(duì)應(yīng)的陰性組,且差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。④ SLE患者有效治療后PD-L1+中性粒細(xì)胞百分率降低(P0.01)。結(jié)論SLE患者外周血中性粒細(xì)胞表面PD-L1表達(dá)異常,與疾病的活動(dòng)性和嚴(yán)重程度以及抗體產(chǎn)生有關(guān)。
[Abstract]:Objective to investigate the expression and clinical significance of programmed death ligand 1 (PD-L1) in peripheral blood neutrophils of patients with systemic lupus erythematosus (SLE). Methods flow cytometry was used to detect the percentage of PD-L1 expression on peripheral blood neutrophils in 77 patients with SLE and 43 healthy controls. The percentage of PD-L1 expression on neutrophils was compared between SLE group and control group, and between SLE active group and stable group. The expression of neutrophil PD-L1 was detected in 10 patients with SLE before and after treatment. Results 1 the percentage of PD-L1 neutrophils in SLE group was significantly higher than that in control group (P0.000 1), and the percentage of PD-L1 neutrophil in active group was higher than that in stable group. The difference was statistically significant (P0. 0027). 2 the percentage of PD-L1 neutrophils in patients with SLE was positively correlated with the SLE disease activity score (SLEDAI),) and the erythrocyte sedimentation rate (ESR) of (ANA), immunoglobulin G (IgG), and the erythrocyte sedimentation rate was positively correlated with the (RBC), hemoglobin (HGB) concentration of erythrocyte count. There was a negative correlation between hematocrit and (HCT). Linear regression analysis showed that the percentage of PD-L1 neutrophils in patients with SLE was significantly different from that of ANA and ESR (P0. 020 / 0. 005). In addition, in the low complement 3 (C3) group and the low leukocyte count group, the percentage of PD-L1 neutrophil was negatively correlated with the C3WBC in the (WBC) group. The low WBC, low platelet count (PLT), hyperneutrophil count was found in the SLE patients. The percentage of PD-L1 neutrophil in hyperneutrophil positive group was higher than that in corresponding negative group, and the difference was statistically significant (P0.05). The percentage of PD-L1 neutrophil in anemia and hematuria positive group was higher than that in the corresponding negative group, and the difference was statistically significant (P0.05). The percentage of PD-L1 neutrophil was decreased after effective treatment in the patients with anemia and hematuria (P0.01). Conclusion the abnormal expression of PD-L1 on peripheral blood neutrophils in patients with SLE is related to the activity and severity of the disease and the production of antibodies.
【作者單位】： 南昌大學(xué)第一附屬醫(yī)院檢驗(yàn)科 江西省血液中心檢驗(yàn)科 南昌大學(xué)醫(yī)學(xué)院
【基金】：江西省青年科學(xué)基金(編號(hào):20151BAB215031)
【分類號(hào)】：R593.241

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