CAJ | 학술논문

目的：通过观察干燥综合征患者心、肺功能的变化与外周血CD19+CD24+Brge及BTLA表达的变化，探讨干燥综合征患者心、肺功能的异常与CD19+CD24+Brge及BTLA的关系。方法：采用超声心动图（UCG）检测64例干燥综合征患者（干燥综合征组）心功能变化，采用肺功能仪检测干燥综合征患者肺功能，采用流式细胞术检测外周血CD19+CD24+Brge及BTLA的表达频率，并与20例健康体检正常者（对照组）进行比较。结果：①干燥综合征组与对照组多普勒超声异常率比较，干燥综合征组多普勒超声心功能变化检测结果异常率为63.33%，对照组异常率为10.00%；干燥综合征组肺功能变化检测结果异常率为79.68%，对照组异常率为20.00%。两组比较，差异有统计学意义（P<0.01）。②与对照组比较，干燥综合征组心功能参数E峰、FS%、E/A比值均显著降低（P<0.01），A峰、LADd显著升高（P<0.01）。③与对照组比较，干燥综合征组肺功能指标IC、MVV、FEF25、FEF50、FEF75、PEF均明显降低（P<0.05或P<0.01）。④与对照组比较，干燥综合征组外周血BTLA占淋巴细胞比例明显降低（P<0.01）， CD19+表达频率、CD24+表达频率、CD19++CD24+表达频率、CD19++BTLA占淋巴细胞比（%）、CD24++CD19+占淋巴细胞比（%）、CD24++BTLA占淋巴细胞比（%）显著升高（P<0.01）。⑤Spearman相关分析结果显示，干燥综合征患者心、肺功能与BTLA占淋巴细胞比（%）呈明显的负相关（P<0.05）， E峰、LADd、PEF与CD19+表达频率、CD24+表达频率、CD19++BTLA占淋巴细胞比（%）、CD24++CD19+占淋巴细胞比（%）、CD24++BTLA占淋巴细胞比（%）均呈显著负相关（P<0.05）；肺功能参数FEV1、FEF50与CD19+表达频率、CD24+表达频率、CD19++BTLA占淋巴细胞比（%）、CD24++CD19+占淋巴细胞比（%）呈显著正相关（P<0.05）。结论：干燥综合征患者在发生炎症的同时，其心、肺功能水平呈下降趋势，同时与外周血BTLA表达降低及CD19+CD24+Brge表达的升高呈相关性，提示Breg调控作用增强，引起免疫失衡，可导致心肺功能的下降。目的：通過觀察榦燥綜閤徵患者心、肺功能的變化與外週血CD19+CD24+Brge及BTLA錶達的變化，探討榦燥綜閤徵患者心、肺功能的異常與CD19+CD24+Brge及BTLA的關繫。方法：採用超聲心動圖（UCG）檢測64例榦燥綜閤徵患者（榦燥綜閤徵組）心功能變化，採用肺功能儀檢測榦燥綜閤徵患者肺功能，採用流式細胞術檢測外週血CD19+CD24+Brge及BTLA的錶達頻率，併與20例健康體檢正常者（對照組）進行比較。結果：①榦燥綜閤徵組與對照組多普勒超聲異常率比較，榦燥綜閤徵組多普勒超聲心功能變化檢測結果異常率為63.33%，對照組異常率為10.00%；榦燥綜閤徵組肺功能變化檢測結果異常率為79.68%，對照組異常率為20.00%。兩組比較，差異有統計學意義（P<0.01）。②與對照組比較，榦燥綜閤徵組心功能參數E峰、FS%、E/A比值均顯著降低（P<0.01），A峰、LADd顯著升高（P<0.01）。③與對照組比較，榦燥綜閤徵組肺功能指標IC、MVV、FEF25、FEF50、FEF75、PEF均明顯降低（P<0.05或P<0.01）。④與對照組比較，榦燥綜閤徵組外週血BTLA佔淋巴細胞比例明顯降低（P<0.01）， CD19+錶達頻率、CD24+錶達頻率、CD19++CD24+錶達頻率、CD19++BTLA佔淋巴細胞比（%）、CD24++CD19+佔淋巴細胞比（%）、CD24++BTLA佔淋巴細胞比（%）顯著升高（P<0.01）。⑤Spearman相關分析結果顯示，榦燥綜閤徵患者心、肺功能與BTLA佔淋巴細胞比（%）呈明顯的負相關（P<0.05）， E峰、LADd、PEF與CD19+錶達頻率、CD24+錶達頻率、CD19++BTLA佔淋巴細胞比（%）、CD24++CD19+佔淋巴細胞比（%）、CD24++BTLA佔淋巴細胞比（%）均呈顯著負相關（P<0.05）；肺功能參數FEV1、FEF50與CD19+錶達頻率、CD24+錶達頻率、CD19++BTLA佔淋巴細胞比（%）、CD24++CD19+佔淋巴細胞比（%）呈顯著正相關（P<0.05）。結論：榦燥綜閤徵患者在髮生炎癥的同時，其心、肺功能水平呈下降趨勢，同時與外週血BTLA錶達降低及CD19+CD24+Brge錶達的升高呈相關性，提示Breg調控作用增彊，引起免疫失衡，可導緻心肺功能的下降。
목적：통과관찰간조종합정환자심、폐공능적변화여외주혈CD19+CD24+Brge급BTLA표체적변화，탐토간조종합정환자심、폐공능적이상여CD19+CD24+Brge급BTLA적관계。방법：채용초성심동도（UCG）검측64례간조종합정환자（간조종합정조）심공능변화，채용폐공능의검측간조종합정환자폐공능，채용류식세포술검측외주혈CD19+CD24+Brge급BTLA적표체빈솔，병여20례건강체검정상자（대조조）진행비교。결과：①간조종합정조여대조조다보륵초성이상솔비교，간조종합정조다보륵초성심공능변화검측결과이상솔위63.33%，대조조이상솔위10.00%；간조종합정조폐공능변화검측결과이상솔위79.68%，대조조이상솔위20.00%。량조비교，차이유통계학의의（P<0.01）。②여대조조비교，간조종합정조심공능삼수E봉、FS%、E/A비치균현저강저（P<0.01），A봉、LADd현저승고（P<0.01）。③여대조조비교，간조종합정조폐공능지표IC、MVV、FEF25、FEF50、FEF75、PEF균명현강저（P<0.05혹P<0.01）。④여대조조비교，간조종합정조외주혈BTLA점림파세포비례명현강저（P<0.01）， CD19+표체빈솔、CD24+표체빈솔、CD19++CD24+표체빈솔、CD19++BTLA점림파세포비（%）、CD24++CD19+점림파세포비（%）、CD24++BTLA점림파세포비（%）현저승고（P<0.01）。⑤Spearman상관분석결과현시，간조종합정환자심、폐공능여BTLA점림파세포비（%）정명현적부상관（P<0.05）， E봉、LADd、PEF여CD19+표체빈솔、CD24+표체빈솔、CD19++BTLA점림파세포비（%）、CD24++CD19+점림파세포비（%）、CD24++BTLA점림파세포비（%）균정현저부상관（P<0.05）；폐공능삼수FEV1、FEF50여CD19+표체빈솔、CD24+표체빈솔、CD19++BTLA점림파세포비（%）、CD24++CD19+점림파세포비（%）정현저정상관（P<0.05）。결론：간조종합정환자재발생염증적동시，기심、폐공능수평정하강추세，동시여외주혈BTLA표체강저급CD19+CD24+Brge표체적승고정상관성，제시Breg조공작용증강，인기면역실형，가도치심폐공능적하강。
Objective:To study changes of heart and lung functions in patients with sj?gren syndrome and their correlativity with CD19+CD24+Brge and BTLA.Methods:Ultrasonic cardiogram (UCG) was used to detect the changes of heart function in 64 cases with sj?gren syndrome,pulmonary function apparatus was applied to test their pulmonary function,and flow cytometry was taken to detect the expression frequency of peripheral blood CD19+CD24+Brge and BTLA,which all were compared with those of the 20 healthy subjects (of the control group).Results: ①The abnormal rate of Doppler ultrasound of the sjogren syndrome group was 63.33%and that of the control group was 10%;the abnormal rate of pulmonary function of the sjogren syndrome group was 79.68% and that of the control group was 20%,the difference between them being statistically signiifcant (P<0.01). ②Compared with the control group,the heart function parameter E peak,FS%and E/A ratio of the sjogren syndrome group signiifcantly decreased (P<0.01),while A peak and LADd signiifcantly increased (P <0.01).③ Compared with the control group,the lung function index such as MVV,FEF25,FEF50,FEF75 and PEF signiifcantly decreased in the sjogren syndrome group(P<0.05 or P<0.01). ④In the sjogren syndrome group,compared with the control group,the ratio of peripheral blood BTLA to lymphocytes decreased signiifcantly (P<0.01);the ratios of CD19+expression frequency,CD24+expression frequency,CD19++CD24+expression frequency and CD19++BTLA frequency to lymphocyte(%),CD24++CD19+to lymphocyte(%),and CD24++BTLA to lymphocyte(%) signiifcantly increased. ⑤The Spearman correlative analysis showed that in patients with sjogrem syndrome the heart-lung functions and the ratio of BTLA to lymphocyte (%)showed a signiifcant negative correlation. E peak,LADd,PEF and CD19+expression frequency,CD24+expression frequency,the ratios of CD19++BTLA to lymphocyte(%),CD24++CD19+to lymphocyte(%),and CD24++BTLA to lymphocyte(%) showed a signiifcant negative correlation(P<0.05). Lung function parameters such as FEV1 and FEF50 and CD19+expression frequency,CD24+expression frequency,the ratios of CD19++BTLA to lymphocyte(%) and CD24++CD19+to lymphocyte (%) showed a signiifcant positive correlation (P<0.05).Conclusion:When there is inlfammation in patients with sjogrem syndrome,the level of their heart-lung function decreased,which was correlated with the decrease of peripheral blood BTLA expression and the increase of CD19+CD24+Brge expression,suggesting that the regulation of Breg enhances,which induces immune imbalance and probably causes the decline of heart-lung function.