[1]王 倩,单新洁,安美玉.系统性红斑狼疮患儿外周血EB病毒载量与T淋巴细胞亚群分布的关系及在肝损伤中的协同作用[J].现代检验医学杂志,2025,40(04):1-7.[doi:10.3969/j.issn.1671-7414.2025.04.001]
　WANG Qian,SHAN XinJie,AN Meiyu.Relationship between Epstein-barr Viral Load and T Lymphocyte Subsets Distribution in Peripheral Blood of Children with Systemic Lupus Erythematosus and Synergistic Effect in Liver Injury[J].Journal of Modern Laboratory Medicine,2025,40(04):1-7.[doi:10.3969/j.issn.1671-7414.2025.04.001]
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系统性红斑狼疮患儿外周血EB病毒载量与T淋巴细胞亚群分布的关系及在肝损伤中的协同作用()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年04期
页码:
1-7
栏目:
论著
出版日期:
2025-07-15

文章信息/Info

Title:
Relationship between Epstein-barr Viral Load and T Lymphocyte Subsets Distribution in Peripheral Blood of Children with Systemic Lupus Erythematosus and Synergistic Effect in Liver Injury
文章编号:
1671-7414（2025）04-001-07
作者:
王 倩a，单新洁b，安美玉c
（北京儿童医院新疆医院，新疆维吾尔自治区儿童医院 a. 儿科研究所；b. 检验科；c. 血液肿瘤科，乌鲁木齐 830054）
Author(s):
WANG Qiana，SHAN XinJieb，AN Meiyuc
(a. Institute of Pediatrics；b. Department of Clinical Laboratory；c.Department of Hematology and Oncology, Xinjiang Hospital of Beijing Children’s Hospital, Xinjiang Uygur Autonomous Region Children’s Hospital，Urumqi 830054，China)
关键词:
系统性红斑狼疮; EB 病毒; T 淋巴细胞; 肝损伤
分类号:
R593.241；R446.6
DOI:
10.3969/j.issn.1671-7414.2025.04.001
文献标志码:
A
摘要:
目的 探究系统性红斑狼疮（SLE）患儿外周血EB 病毒（EBV）载量与T 淋巴细胞亚群分布的关系及在肝损伤中的协同作用。方法 选取2021 年10 月～ 2023 年9 月新疆维吾尔自治区儿童医院收治的212 例SLE 患儿作为研究对象，根据SLE 疾病活动指数（SLEDAI）评分分为活动组（n=58）和非活动组（n=154）。比较两组患儿临床资料和实验室指标。采用局部加权散点图平滑（LOWESS）方法分析EBV 载量与T 淋巴细胞之间的曲线关联。根据肝损伤发生情况，将212 例SLE 患儿分为无肝损伤组（n=166）和肝损伤组（n=46），比较两组患儿临床资料，采用多因素Logistics 回归分析筛选SLE 患儿肝损伤的影响因素。采用限制性立方样条（RCS）模型分析EBV 载量及T 淋巴细胞与肝损伤的关系。采用非条件Logistic 回归模型分析EBV 载量与T 淋巴细胞对肝损伤的交互作用。结果 与非活动组相比，活动组患儿年龄较低（t=9.265）、激素使用剂量较高（t=2.369），ALB，CD4+，CD4+/CD8+ 水平下降（t=8.870，3.463，5.820），EBV 载量、CD3+，CD8+ 水平上升（t=40.830，12.719，5.048），差异具有统计学意义（均P<0.05）。LOWESS 分析结果显示，EBV 载量与CD3+，CD4+，CD8+，CD4+/CD8+ 具有一定的非线性关系。肝损伤组患儿病程≤ 3 月占比、EBV 载量、CD3+，CD8+ 水平及活动性患儿占比低于无肝损伤组（t/χ2=10.749~30.378）；ALB，CD4+，CD4+/CD8+ 指标水平高于无肝损伤组（t=13.561，3.117，13.201），差异具有统计学意义（均P<0.05）。多因素Logistic 回归分析结果显示，病程≤ 3 月、EBV 载量、CD3+，ALB，CD4+/CD8+，活动性SLE 是影响SLE 患儿肝损伤的危险因素（Waldχ2=1.020 ～ 1.932，均P<0.05）。RCS 模型分析结果显示，外周血EBV 载量、CD3+，CD8+ 与SLE 患儿肝损伤呈正相关关系，CD4+，CD4+/CD8+ 与SLE 患儿肝损伤呈负相关关系。交互作用分析结果显示，EBV 载量≥ 450IU/ml 与CD3+ ≥ 60%，CD4+<30%，CD8+ ≥ 37% 及CD4+/CD8+<0.94 存在相乘相加交互作用，即两种因素共同存在时SLE 患儿肝损伤发生风险更高。结论 SLE 患儿外周血EBV 载量与CD3+，CD4+，CD8+，CD4+/CD8+ 均具有一定的非线性关系。外周血EBV 载量、CD3+，CD4+，CD8+，CD4+/CD8+ 异常表达均是SLE 患儿发生肝损伤的影响因素，且上述各因素之间存在相乘相加交互作用。
Abstract:
Objective To explore the relationship between epstein-barr viral (EBV) load and T lymphocyte subsets distribution in peripheral blood of children with systemic lupus erythematosus (SLE) and its synergistic effect on liver injury. Methods A total of 212 children with SLE admitted to the Xinjiang Uygur Autonomous Region Children’s Hospital from October 2021 to September 2023 were selected as the study subjects. The SLE disease activity index (SLEDAI) score was divided into active group (n=58) and inactive group (n=154). The clinical data and laboratory indexes of the two groups were compared. The curve relationship between EBV load and T lymphocytes was analyzed by local weighted scatterplot smoothing (LOWESS) method.According to the occurrence of liver injury, 212 children with SLE were divided into two groups (n=166) without liver injury and (n=46) with liver injury. The clinical data of the two groups were compared. Multifactor Logistics regression analysis was used to screen the influencing factors of liver injury in SLE children. Restricted cubic spline (RCS) model was used to analyze the relationship between EBV load, T lymphocytes and liver injury. The unconditioned Logistic regression model was used to analyze the interaction between EBV load and T lymphocytes on liver injury. Results Compared with the inactive group, the active group had younger age (t=9.265), higher hormone dosage (t=2.369), decreased ALB, CD4+, CD4+/CD8+levels (t=4.870, 3.463, 5.820), and increased EBV load, CD3+, CD8+levels (t=40.830，12.719，5.048), and the differences were statistically significant（all P<0.05）. LOWESS analysis showed that EBV load had a nonlinear relationship with CD3+, CD4+, CD8+ and CD4+/CD8+. The proportion of children with liver injury who had a disease course of ≤ 3 months, EBV load, CD3+ and CD8+ levels, and the proportion of active children were lower than those without liver injury (t/χ2=10.749~30.378); the levels of ALB, CD4+ and CD4+/CD8+ indexes were higher than those without live injury (t=13.561, 3.117, 13.204), and the differences were statistically significantly (all P<0.05). Multivariate Logistic regression analysis showed that disease duration ≤ 3 months, EBV load, CD3+, ALB, CD4+/CD8+ and active SLE were influential factors for liver injury in SLE children （Wald χ2=1.020 ～ 1.932， all P<0.05）. The results of RCS model analysis showed that EBV load, CD3+ and CD8+ were positively correlated with liver injury in SLE children, and CD4+, CD4+/CD8+ were negatively correlated with liver injury in SLE children . Interaction analysis results showed that EBV load ≥ 450 IU/ml had a multiplicative and additive interaction with CD3+ ≥ 60%, CD4+<30%, CD8+ ≥ 37% and CD4+/CD8+<0.94, and the risk of liver injury in SLE children was higher when the two factors co-existed. Conclusion There is a nonlinear relationship between EBV load in peripheral blood of SLE children and CD3+, CD4+, CD8+ and CD4+/CD8+. Peripheral blood EBV load and abnormal expression of CD3+, CD4+, CD8+ and CD4+/CD8+ are all factors affecting liver injury in children with SLE, and there is a multiplicative and additive interaction between the above factors.

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备注/Memo

备注/Memo:
基金项目：新疆维吾尔自治区自然科学基金（项目编号：2022D01B193）。
作者简介： 王倩（1991-）， 女， 实习研究员， 研究生， 主要从事生物化学与分子生物学、细胞遗传学的基础研究，E-mail：1620388943@qq.com。
通讯作者： 单新洁（1981-），女，本科，副主任技师，主要从事儿童血液病外周血及骨髓形态学的检测及诊断、儿童自身免疫性疾病自身抗体的检测，E-mail：52994296@qq.com。
更新日期/Last Update: 2025-07-15