系统性红斑狼疮伴人巨细胞病毒IgM抗体阳性与阴性患者的临床特征比较

doi:10.13481/j.1671-587x.20160625

吉林大学学报(医学版) ›› 2016, Vol. 42 ›› Issue (06): 1178-1182.doi: 10.13481/j.1671-587x.20160625

系统性红斑狼疮伴人巨细胞病毒IgM抗体阳性与阴性患者的临床特征比较

刘薇薇, 张晓莉, 王晓非

中国医科大学附属盛京医院风湿免疫科, 辽宁沈阳 110023

收稿日期:2016-05-15 出版日期:2016-11-28 发布日期:2016-12-02
通讯作者: 张晓莉,副教授,硕士研究生导师(Tel:024-96615-1-27111,E-mail:zhangxl3@sj-hosipital.org) E-mail:zhangxl3@sj-hosipital.org
作者简介:刘薇薇(1989-),女,辽宁省沈阳市人,医师,医学硕士,主要从事风湿免疫学方面的研究。
基金资助:
辽宁省科技厅社会发展科技攻关项目资助课题（F12-193-9-41）

Comparisonof clinical characteristics between HCMV-IgM positive and HCMV-IgM negative patients with systemic lupus erythematosus

LIU Weiwei, ZHANG Xiaoli, WANG Xiaofei

Department of Rheumatology, Affiliated Shengjing Hosipital, China Medical University, Shenyang 110023, China

Received:2016-05-15 Online:2016-11-28 Published:2016-12-02

摘要/Abstract

摘要：

目的：比较人巨细胞病毒（HCMV）-IgM抗体阳性和阴性的系统性红斑狼疮（SLE）患者的临床特征，为SLE的临床诊治提供依据。方法：选择HCMV-IgM阳性患者63例，HCMV-IgM阴性患者66例，按照是否经过糖皮质激素及免疫抑制剂治疗分为初治组（n=48）和复治组（n=81），比较2组患者常见临床表现的发生率、狼疮活动指数（SLEDAI）、CD4⁺T和CD8⁺T细胞绝对值及CD4⁺/CD8⁺比值。结果：贫血、发热、肝功能异常、白细胞（WBC）数目减少和皮疹可能是SLE患者常见的临床表现。HCMV-IgM阳性组患者皮疹、关节炎、心包积液、肾功能异常的发生率和SLEDAI均高于HCMV-IgM阴性组（P<0.05）；HCMV-IgM阳性组患者CD4⁺T细胞绝对值低于HCMV-IgM阴性组患者，CD8⁺T细胞绝对值高于HCMV-IgM阴性组患者，但组间比较差异无统计学意义（P>0.05）。初治组患者中HCMV-IgM阳性患者皮疹和关节炎的发生率高于HCMV-IgM阴性患者（P<0.05）；复治组HCMV-IgM阳性和HCMV-IgM阴性患者的临床表现发生率比较差异无统计学意义（P>0.05）。结论：HCMV-IgM阳性和阴性的SLE患者临床表现不同，阳性患者病情较阴性患者更严重。

关键词: 系统性红斑狼疮, 狼疮活动指数, T淋巴细胞, 人巨细胞病毒

Abstract:

Objective: To compare the clinical characteristics between the systemic lupus erythematosus (SLE) patients with positive human cytomegalovirus (HCMV)-IgM antibody and negative HCMV-IgM antibody, and to provide basis for the clinical diagnosis and treatment of SLE.Methods: A total of 63 SLE patients with positive HCMV-IgM and 66 SLE patients with negative HCMV-IgM were selected.The patients who had never used corticosteroid hormone or immunosuppressive drugs were included in initial treatment group(n=48),while those who used either of them were included in retreatment group(n=81).The incidence of clinical manifestations,SLE disease activity index (SLEDAI), absolute counts of CD4⁺ T and CD8⁺T lymphocytes,and CD4⁺/CD8⁺ ratio of the patients in two groups were compared.Results: The anemia,fever,liver dysfunction,leukopenia, and rash were the most common clinical manifestations of the SLE patients.The incidence rates of rash,arthritis,serositis and renal dysfunction and SLEDAI in positive HCMV-IgM group were higher than those in negative HCMV-IgM group (P<0.05). Compared with negative HCMV-IgM group,the absolute count of CD4⁺T lymphocytes was decreased,and the absolute count of CD8⁺ T lymhocytes was increased in positive HCMV-IgM group (P>0.05). The incidence rates of rash and arthritis of the patients with positive HCMV-IgM in initial treatment group were higher than those patients with negative HCMV-IgM (P<0.05). The incidence rates of clinical manifestations of the patients with positive HCMV-IgM and with negative HCMV-IgM in retreatment group had no significant differences(P>0.05).Conclusion: The clinical manifestations of the SLE patients with positive and negative HCMV-IgM are different,and the manifestations of patients with positive HCMV-IgM are more serious.

Key words: human cytomegalovirus, T lymphocyte, systemic lupus erythematosus, systemic lupus erythematosus disease activity index

中图分类号:

R593.24

刘薇薇, 张晓莉, 王晓非. 系统性红斑狼疮伴人巨细胞病毒IgM抗体阳性与阴性患者的临床特征比较[J]. 吉林大学学报(医学版), 2016, 42(06): 1178-1182.

LIU Weiwei, ZHANG Xiaoli, WANG Xiaofei. Comparisonof clinical characteristics between HCMV-IgM positive and HCMV-IgM negative patients with systemic lupus erythematosus[J]. Journal of Jilin University Medicine Edition, 2016, 42(06): 1178-1182.

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系统性红斑狼疮伴人巨细胞病毒IgM抗体阳性与阴性患者的临床特征比较

Comparisonof clinical characteristics between HCMV-IgM positive and HCMV-IgM negative patients with systemic lupus erythematosus

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