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生育期系统性红斑狼疮患者卵巢储备功能、月经及淋巴细胞亚群变化的初步研究。

Preliminary study on the changes of ovarian reserve, menstruation, and lymphocyte subpopulation in systemic lupus erythematosus (SLE) patients of childbearing age.

机构信息

Department of Rheumatology and Immunology, Tangdu Hospital of The Fourth Military Medical University, Xi'an, China.

出版信息

Lupus. 2018 Mar;27(3):445-453. doi: 10.1177/0961203317726378. Epub 2017 Aug 18.

DOI:10.1177/0961203317726378
PMID:28820360
Abstract

Objective The main aim of this study was to investigate the ovarian reserve, menstruation, and lymphocyte subpopulation in systemic lupus erythematosus (SLE) patients of childbearing age. Methods We enrolled 40 SLE patients of childbearing age and 40 age-matched healthy controls. Anti-Müllerian hormone (AMH) was tested by electrochemiluminescence, and lymphocyte subsets were tested by flow cytometry. Menstruation situation was obtained by interview. Results The AMH level of the SLE group was significantly lower than that of the control group ( p < 0.001), which was negatively correlated with erythrocyte sedimentation rate (ESR ( r = -0.316, p = 0.047)) and disease activity (SLEDAI ( r = -0.338, p = 0.033)). The AMH concentration of SLE patients with normal menstruation was higher than those with abnormal menstruation ( p < 0.001). The percentages of CD4 T lymphocytes and NK (natural killer) cells in the SLE group were significantly lower than those in the control group ( p < 0.001). However, the percentages of B cells and CD8 T lymphocytes in the SLE group were higher than those in the control group ( p < 0.05). Conclusion Decreased AMH and high incidence of abnormal menstruation indicated that autoimmunity activities of SLE can impair the ovarian reserve of female patients. Lymphocytes in SLE patients were in a state of disorder.

摘要

目的

本研究旨在探讨生育期系统性红斑狼疮(SLE)患者的卵巢储备功能、月经情况和淋巴细胞亚群。

方法

共纳入 40 例生育期 SLE 患者和 40 例年龄匹配的健康对照者。采用电化学发光法检测抗苗勒管激素(AMH),流式细胞术检测淋巴细胞亚群。通过访谈获得月经情况。

结果

SLE 组 AMH 水平明显低于对照组(p<0.001),与红细胞沉降率(ESR(r=-0.316,p=0.047))和疾病活动度(SLEDAI(r=-0.338,p=0.033))呈负相关。月经正常的 SLE 患者的 AMH 浓度高于月经异常的患者(p<0.001)。SLE 组 CD4 T 淋巴细胞和 NK(自然杀伤)细胞的比例明显低于对照组(p<0.001)。然而,SLE 组 B 细胞和 CD8 T 淋巴细胞的比例高于对照组(p<0.05)。

结论

AMH 降低和月经异常发生率高表明 SLE 的自身免疫活动可损害女性患者的卵巢储备功能。SLE 患者的淋巴细胞处于紊乱状态。

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