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[白塞病患者葡萄膜炎的临床免疫紊乱]

[Clinical-immunological disorders in uveitis in patients with Behçet's syndrome].

作者信息

Teplinskaia L E, Kaliberdina A F, Zaĭtseva N S, Bulanova T D, Katsnel'son L A

出版信息

Vestn Oftalmol. 1994 Jul-Sep;110(3):23-5.

PMID:7810037
Abstract

The results of comprehensive clinicoimmunologic examinations of 38 uveitis patients with Behçet's disease indicate that uveitis in the presence of Behçet's disease should be referred to multifactorial diseases to whose pathogenesis immunopathologic reactions in various combinations and genetic predisposition contribute much. Generalization of the process in the eye predominated in the clinical picture with involvement of the anterior and posterior segments, retinal vessels, this being combined with general somatic symptoms (aphthae on the buccal mucosa, genitals, arthritides, urethritis/cystitis symptoms, positive 'pricking' test). Study of the immunity status revealed depressed lymphocyte proliferative response to mitogen in 58.8% of patients, hyperimmunoglobulinemia of the A and M classes in 63.3%, impaired complex formation (increased levels of circulating immune complexes in 78.3% and cryoglobulin presence in 57.1%), and various combinations of these immunologic signs. The results indicated patients' infection with herpes virus, streptococcus, toxoplasma. An associative connection of Behçet's disease with A (II) red cell phenotype in 54.8% of patients (p < 0.05) suggests a relationship between genetic factors and the conditions of a specific geographic region. A variety of immunologic changes necessitated the use of corticosteroids, hemoperfusion, cytostatics, and immunity stimulants in the treatment of uveitis in Behçet's disease patients.

摘要

对38例白塞病葡萄膜炎患者进行综合临床免疫学检查的结果表明,白塞病伴发的葡萄膜炎应归为多因素疾病,其发病机制中多种免疫病理反应的组合以及遗传易感性起了很大作用。眼部病变的扩散在临床表现中占主导,累及眼前段和后段、视网膜血管,并伴有全身症状(颊黏膜、生殖器口腔溃疡、关节炎、尿道炎/膀胱炎症状、“针刺”试验阳性)。免疫状态研究显示,58.8%的患者对丝裂原的淋巴细胞增殖反应降低,63.3%的患者A类和M类免疫球蛋白血症升高,复合物形成受损(78.3%的患者循环免疫复合物水平升高,57.1%的患者存在冷球蛋白),以及这些免疫体征的各种组合。结果表明患者感染了疱疹病毒、链球菌、弓形虫。54.8%的患者白塞病与A(II)红细胞表型存在关联(p<0.05),提示遗传因素与特定地理区域的条件之间存在关系。多种免疫变化使得在治疗白塞病患者的葡萄膜炎时需要使用皮质类固醇、血液灌注、细胞抑制剂和免疫刺激剂。

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