系统性红斑狼疮患者单核细胞亚群分布与病情的相关性

doi:10.3969/j.issn.1673-8640.2026.01.004

摘要/Abstract

摘要：

目的探讨系统性红斑狼疮（SLE）患者外周血单核细胞亚群与病情的相关性。方法选取2022年1—8月川北医学院附属医院SLE患者67例（SLE组）、健康体检者46名（正常对照组）。收集所有研究对象的年龄、性别等一般资料和单核细胞百分比（MO%）、单核细胞亚群[经典型单核细胞百分比（CM%）、中间型单核细胞百分比（IM%）、非经典型单核细胞百分比（NCM%）]，以及SLE患者的疾病活动性指标[单核细胞绝对数（MO#）、红细胞沉降率（ESR）、C反应蛋白（CRP）、补体（C）3、C4、抗双链DNA（dsDNA）抗体、抗核抗体（ANA）]检测结果。采用Spearman秩相关分析评估SLE患者MO#、CM%、IM%与疾病活动性指标的相关性。采用Logistic回归分析评估SLE疾病活动性的影响因素。采用受试者工作特征（ROC）曲线评价CM%和IM%诊断SLE的效能。结果与正常对照组比较，SLE组MO#、MO%、IM%升高（P<0.001），CM%降低（P<0.001），NCM%差异无统计学意义（P>0.05）；SLE缓解组MO#、MO%、IM%升高（P<0.05），CM%、NCM%差异无统计学意义（P>0.05）。与SLE缓解组比较，SLE活动组CM%降低（P<0.001），IM%升高（P<0.001），MO#、MO%、NCM%差异均无统计学意义（P>0.05）。SLE活动组CM%与CRP、抗dsDNA抗体水平均呈负相关（P<0.05），与C3、C4水平均呈正相关（P<0.05）；IM%与CRP、抗dsDNA抗体水平均呈正相关（P<0.05），与C4水平呈负相关（P<0.05）。年龄较小和IM%升高是SLE患者疾病活动性的危险因素[比值比（OR）值分别为0.948、2.410，95%可信区间（CI）分别为0.900~0.998、1.386~4.192，P<0.05]。CM%和IM%诊断SLE的曲线下面积（AUC）分别为0.785、0.827，判断SLE疾病活动性的AUC分别为0.951、0.966。结论单核细胞亚群分布与SLE疾病活动性密切相关，或可作为SLE诊断和疾病活动性评估的新的生物标志物。

关键词: 单核细胞亚群, 经典型单核细胞, 中间型单核细胞, 非经典型单核细胞, 系统性红斑狼疮

Abstract:

Objective To investigate the correlation between peripheral blood monocyte subsets and disease status in patients with systemic lupus erythematosus（SLE）. Methods A total of 67 SLE patients（SLE group）and 46 healthy subjects（healthy control group）were enrolled from the Affiliated Hospital of North Sichuan Medical College from January to August 2022. The general data such as age and gender and the determination results of the percentage of monocytes（MO%），the percentage of classical monocytes（CM%），the percentages of intermediate monocytes（IM%），the percentages of non-classical monocytes（NCM%）and disease activity indicators [the absolute value of monocytes（MO#），erythrocyte sedimentation rate（ESR），C-reactive protein（CRP），complement（C）3，C4，anti-double-stranded DNA（dsDNA）antibody，anti-nuclear antibody （ANA）] were collected. Spearman rank correlation analysis was used to evaluate the correlation between MO#，CM%，IM% and disease activity indicators of SLE patients. Logistic regression analysis was used to evaluate the influencing factors of SLE disease activity. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of CM% and IM% in diagnosing SLE. Results Compared with healthy control group，MO#，MO% and IM% in SLE group were increased（P<0.001），CM% was decreased（P<0.001），and there was no statistical significance in NCM%（P>0.05）. MO#，MO% and IM% in SLE remission group were increased（P<0.05），while CM% and NCM% were not statistically significant（P>0.05）. Compared with SLE remission group，CM% in SLE active group was decreased（P<0.001），IM% was increased（P<0.001），and there was no statistical significance in MO#，MO% and NCM%（P>0.05）. CM% was negatively correlated to CRP and anti-dsDNA antibody levels in SLE active group（P<0.05），and it was positively correlated to C3 and C4 levels（P<0.05）. IM% was positively correlated with CRP and anti-dsDNA antibody levels（P<0.05），and it was negatively correlated to C4 level（P<0.05）. Age being younger and IM% being higher were risk factors for disease activity in SLE patients [odds ratios（OR）were 0.948 and 2.410，95% confidence intervals（CI）were 0.900-0.998 and 1.386-4.192，P<0.05]. The areas under curves（AUC）of CM% and IM% for diagnosing SLE were 0.785 and 0.827，respectively，and the AUC for evaluating SLE disease activity were 0.951 and 0.966，respectively. Conclusions The distribution of monocyte subsets is related to the disease activity of SLE，and it may be a new biomarker for the diagnosis and assessment of SLE disease activity.

Key words: Monocyte subset, Classical monocyte, Intermediate monocyte, Non-classical monocyte, Systemic lupus erythematosus

中图分类号:

R446.1

尹秀杉, 谭雪玲, 何仁栋, 邢艳. 系统性红斑狼疮患者单核细胞亚群分布与病情的相关性[J]. 检验医学, 2026, 41(1): 20-27.

YIN Xiushan, TAN Xueling, HE Rendong, XING Yan. Correlation between monocyte subset distribution in patients with systemic lupus erythematosus and disease status[J]. Laboratory Medicine, 2026, 41(1): 20-27.

图/表 10

参考文献 35

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组别	例数	性别		年龄/岁	ESR/（mm·h-1）	CRP/（mg·L^-1）
组别	例数	男/例	女/例	年龄/岁	ESR/（mm·h-1）	CRP/（mg·L^-1）
SLE活动组	33	3	30	39.50（30.75，51.25）	14（10，22）	2.07（0.68，5.63）
SLE缓解组	34	4	30	41.00（33.25，52.25）	8（2，18）	0.76（0.29，2.07）
正常对照组	46	4	42	41.07（31.50，52.00）
统计值		0.232		2.592	370.50	217.50
P值		0.891		0.274	0.016	0.037
组别	C3/（mg·L^-1）			C4/（mg·L^-1）	抗dsDNA抗体/（IU·mL^-1）	ANA滴度
SLE活动组	753.0（653.5，879.0）			161.0（123.0，244.0）	15.84（2.94，63.38）	1（0，2）
SLE缓解组	756.5（679.8，882.3）			171.0（127.3，224.5）	1.70（1.00，11.70）	1（0，1）
正常对照组
统计值	525.00			546.50	312.50	474.00
P值	0.656			0.856	0.002	0.246

组别	例数	性别		年龄/岁	ESR/（mm·h-1）	CRP/（mg·L^-1）
组别	例数	男/例	女/例	年龄/岁	ESR/（mm·h-1）	CRP/（mg·L^-1）
SLE活动组	33	3	30	39.50（30.75，51.25）	14（10，22）	2.07（0.68，5.63）
SLE缓解组	34	4	30	41.00（33.25，52.25）	8（2，18）	0.76（0.29，2.07）
正常对照组	46	4	42	41.07（31.50，52.00）
统计值		0.232		2.592	370.50	217.50
P值		0.891		0.274	0.016	0.037
组别	C3/（mg·L^-1）			C4/（mg·L^-1）	抗dsDNA抗体/（IU·mL^-1）	ANA滴度
SLE活动组	753.0（653.5，879.0）			161.0（123.0，244.0）	15.84（2.94，63.38）	1（0，2）
SLE缓解组	756.5（679.8，882.3）			171.0（127.3，224.5）	1.70（1.00，11.70）	1（0，1）
正常对照组
统计值	525.00			546.50	312.50	474.00
P值	0.656			0.856	0.002	0.246

组别	例数	MO#/（×109L^-1）	MO%/%	CM%/%	IM%/%	NCM%/%
正常对照组	46	0.29（0.24，0.34）	5.37（4.85，6.66）	95.81（94.06，97.05）	1.97（1.35，3.32）	1.87（1.11，2.67）
SLE组	67	0.37（0.30，0.52）	7.97（6.20，9.72）	92.31（88.38，94.45）	5.79（3.47，8.33）	1.93（1.02，2.71）
U值		758.50	663.50	662.00	532.50	1 540.00
P值		<0.001	<0.001	<0.001	<0.001	0.995

组别	例数	MO#/（×109L^-1）	MO%/%	CM%/%	IM%/%	NCM%/%
正常对照组	46	0.29（0.24，0.34）	5.37（4.85，6.66）	95.81（94.06，97.05）	1.97（1.35，3.32）	1.87（1.11，2.67）
SLE组	67	0.37（0.30，0.52）	7.97（6.20，9.72）	92.31（88.38，94.45）	5.79（3.47，8.33）	1.93（1.02，2.71）
U值		758.50	663.50	662.00	532.50	1 540.00
P值		<0.001	<0.001	<0.001	<0.001	0.995

组别	例数	MO#/（×109L^-1）	MO%/%	CM%/%	IM%/%	NCM%/%
SLE活动组	33	0.37（0.30，0.50）	7.97（5.98，10.93）	90.66（85.02，92.30）	7.89（5.82，10.27）	2.12（1.26，2.60）
SLE缓解组	34	0.39（0.29，0.54）	8.03（6.30，9.35）	94.26（92.30，97.05）	3.64（1.63，5.80）	1.42（0.93，2.83）
U值		544.50	558.00	188.50	171.00	473.00
P值		0.836	0.970	<0.001	<0.001	0.270