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回顾性分析结核病对系统性红斑狼疮(SLE)患者的影响。

Retrospective analysis on the impact of tuberculosis on patients with systemic lupus erythematosus (SLE).

机构信息

Department of Internal Medicine, Huang Pu Hospital of the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, China.

出版信息

Rheumatol Int. 2013 Jan;33(1):25-8. doi: 10.1007/s00296-011-2358-0. Epub 2012 Jan 3.

DOI:10.1007/s00296-011-2358-0
PMID:22212413
Abstract

Up to now, there have been few reports concerning changes in lupus activity and immune indices of tuberculosis in patients with systemic lupus erythematosis (SLE). A retrospective investigation was given to survey the case data of SLE patients companied with tuberculosis that were treated in our hospital from 2001 to 2010 and compared with that of sex- and age-matched patients with single SLE. Changes in autoantibodies, lupus activity, inflammatory indices, positive rates of tuberculin (PPD) test and tuberculosis antibody (TB-Ab) of both groups were observed. It was indicated by results that ANA antibody level and positive rates of anti-Sm, anti-SSA and anti-SSB antibodies were significantly lower in the TB group than those in the control group (P < 0.05); C3 and C4 levels were significantly higher in the TB group than those in the control group; damage of hematological system (predominantly platelet) was less severe in the TB group than that in the control group (P < 0.05); no significant differences in IgG, IgM and IgA were noted between two groups (P > 0.05); ESR, C-reactive protein and LDH levels were significantly higher in the TB group than those in the control group (P < 0.05); PPD-IgG were significantly higher in the TB group than those in the control group (P < 0.05). These results suggested that after SLE patients were infected with tuberculosis, immune function was altered and lupus activity was inhibited as well.

摘要

截至目前,有关系统性红斑狼疮(SLE)患者结核活动和免疫指标变化的报道较少。本研究回顾性调查了我院 2001 年至 2010 年收治的合并肺结核的 SLE 患者的病例资料,并与性别和年龄匹配的单纯 SLE 患者进行比较。观察两组自身抗体、狼疮活动、炎症指标、结核菌素(PPD)试验和结核抗体(TB-Ab)阳性率的变化。结果表明,TB 组 ANA 抗体水平及抗 Sm、抗 SSA 和抗 SSB 抗体阳性率均显著低于对照组(P<0.05);TB 组 C3 和 C4 水平显著高于对照组;TB 组血液系统(主要为血小板)损伤较对照组轻(P<0.05);两组 IgG、IgM 和 IgA 差异无统计学意义(P>0.05);TB 组 ESR、C 反应蛋白和 LDH 水平显著高于对照组(P<0.05);TB 组 PPD-IgG 显著高于对照组(P<0.05)。这些结果表明,SLE 患者感染结核后,免疫功能发生改变,狼疮活动受到抑制。

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