Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, and Universidad Científica del Sur, Lima, Perú.
Diagnostic Support Department, Hospital Grau, EsSalud, Lima, Perú.
Clin Exp Rheumatol. 2018 Nov-Dec;36(6):1008-1013. Epub 2018 May 8.
To determine whether the CD4+CD28null T-cells subpopulation predicts the occurrence of damage in SLE.
This longitudinal study was conducted in consecutive SLE patients seen every six months in our Rheumatology Department since 2012. Patients in whom CD4+CD28null T-cells had been measured and who had at least one subsequent visit were included in the study. Survival analyses (univariable and multivariable Cox-regression models) were performed to determine the risk of overall and domain damage (as per the SLICC Damage Index - SDI) as a function of the frequency of this T-cell subpopulation. The multivariable model was adjusted for pertinent confounders. All analyses were performed using SPSS 21.0.
One hundred and nineteen patients were evaluated; their mean (SD) age was 43.5 (11.9) years, 113 (95.0%) were female. Disease duration was 7.8 (7.0) years, the SLEDAI 5.3 (4.1) and the SDI 1.0 (1.4). The percentage of CD4+CD28null T-cells was 17.4 (14.0). The mean follow-up was 2.1 (0.8) years, and the mean number of visits per patient 3.5 (1.1). Forty-six (38.7%) patients increase at least one SDI point. In the univariable and multivariable analyses, the percentage of CD4+CD28null predicted the occurrence of lung damage [HR: 1.042 (CI95%: 1.001-1.085); p=0.047 and HR: 1.099 (CI95%1.020-1.184); p=0.013, respectively] but neither the total SDI score nor all other SDI domain scores were predicted by the percentage of CD4+CD28null cells.
In SLE patients, CD4+CD28null T-cells predict the occurrence of new lung damage, independently of other risk factors but not of overall damage or damage on other domains.
确定 CD4+CD28null T 细胞亚群是否可预测 SLE 患者发生损伤。
本纵向研究于 2012 年起在我院风湿科连续纳入每 6 个月就诊的 SLE 患者，入组标准为进行过 CD4+CD28null T 细胞检测且至少有一次后续就诊的患者。采用单变量和多变量 Cox 回归模型进行生存分析，以评估该 T 细胞亚群频率与总损伤（按 SLICC 损伤指数-SDI）和各领域损伤（按 SLICC 损伤指数-SDI）的风险函数关系。多变量模型根据相关混杂因素进行了调整。所有分析均使用 SPSS 21.0 进行。
共评估了 119 例患者，其平均（标准差）年龄为 43.5（11.9）岁，113 例（95.0%）为女性。疾病持续时间为 7.8（7.0）年，SLEDAI 评分为 5.3（4.1），SDI 为 1.0（1.4）。CD4+CD28null T 细胞百分比为 17.4（14.0）。平均随访时间为 2.1（0.8）年，平均每位患者就诊次数为 3.5（1.1）次。46 例（38.7%）患者的 SDI 评分至少增加 1 分。在单变量和多变量分析中，CD4+CD28null 细胞百分比预测了肺部损伤的发生[风险比（HR）：1.042（95%可信区间：1.001-1.085）；p=0.047 和 HR：1.099（95%可信区间：1.020-1.184）；p=0.013]，但 CD4+CD28null 细胞百分比既不能预测总 SDI 评分，也不能预测其他 SDI 领域评分。
在 SLE 患者中，CD4+CD28null T 细胞可预测新的肺部损伤发生，这与其他危险因素无关，但与总损伤或其他领域的损伤无关。
