系统性红斑狼疮患者外周血中性粒细胞PD-L1表达和临床意义

发布时间：2018-09-12 13:24

【摘要】：目的探讨程序性死亡配体1(PD-L1)在系统性红斑狼疮(SLE)患者外周血中性粒细胞上的表达及临床意义。方法应用流式细胞仪检测77例SLE患者和43例健康对照者外周血中性粒细胞表面PD-L1表达百分率,比较SLE组和对照组之间以及SLE活动组和稳定组中性粒细胞表面PD-L1表达百分率,分析其与SLE临床表现及实验室检查指标的相关性,并检测10例SLE患者治疗前后中性粒细胞PD-L1的表达。结果① SLE组外周血PD-L1+中性粒细胞百分率高于对照组,差异有统计学意义(P0.000 1);活动组PD-L1+中性粒细胞百分率高于稳定组,差异有统计学意义(P=0.002 7)。② SLE患者PD-L1+中性粒细胞百分率与SLE疾病活动性评分(SLEDAI)、抗核抗体(ANA)、免疫球蛋白G(IgG)、红细胞沉降率(ESR)呈正相关性,与红细胞计数(RBC)、血红蛋白(HGB)浓度、红细胞压积(HCT)呈负相关性,对这些呈线性相关的变量进行线性回归分析显示SLE患者PD-L1+中性粒细胞百分率与ANA和ESR的线性回归差异有统计学意义(P=0.020、0.005)。以外,在低补体3(C3)组和低白细胞计数(WBC)组中,SLE患者PD-L1+中性粒细胞百分率与C3、WBC呈负相关性。SLE患者中低WBC、低血小板计数(PLT)、高中性粒细胞数、高中性粒细胞百分比阳性组PD-L1+中性粒细胞百分率均高于对应的阴性组,差异均有统计学意义(P0.05)。③ SLE患者发热、皮肤表现、低白细胞血症、低红细胞血症、低血小板血症、贫血和血尿阳性组PD-L1+中性粒细胞百分率均高于对应的阴性组,且差异均有统计学意义(P0.05)。④ SLE患者有效治疗后PD-L1+中性粒细胞百分率降低(P0.01)。结论SLE患者外周血中性粒细胞表面PD-L1表达异常,与疾病的活动性和严重程度以及抗体产生有关。
[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.
【作者单位】：南昌大学第一附属医院检验科江西省血液中心检验科南昌大学医学院
【基金】：江西省青年科学基金(编号:20151BAB215031)
【分类号】：R593.241

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