摘要目的:探讨不同类型的自身免疫病(autoimmune disease，AID)患者外周血淋巴细胞亚群数量及差异。方法:纳入2023年1月至2023年8月就诊于空军军医大学第二附属医院147例AID患者作为AID组。根据病因将AID组分为血管炎组(19例)，干燥综合征组(13例)，类风湿性关节炎组(20例)，强直性脊柱炎组(5例)，系统性红斑狼疮组(74例)，系统性硬化症组(8例)和抗磷脂综合征组(8例)。选取同期送检的42例健康志愿者标本作为对照组。采用流式细胞术检测外周血淋巴细胞亚群数量。结果:与对照组相比，AID患者淋巴细胞亚群CD3 ＋、CD3 ＋CD4 ＋、CD3 ＋CD8 ＋、CD3 －CD19 ＋、CD3 －CD16 ＋CD56 ＋均显著降低，差异有统计学意义( Z＝－7.00，－4.34，－2.62，－4.77，－6.51， P值均<0.05)。各亚组AID患者CD3 ＋T、CD3 ＋CD4 ＋T、CD3 ＋CD8 ＋T淋巴细胞绝对计数差异均有统计学意义( H＝19.86，28.66，12.66， P值均<0.05)。其中，与系统性红斑狼疮患者相比，抗磷脂综合征患者CD3 ＋T、CD3 ＋CD4 ＋T绝对计数均显著升高，强制性脊柱炎患者CD3 ＋CD4 ＋T绝对计数显著升高，差异有统计学意义( P＝ 0.012、0.002、0.038 )。各亚组AID患者CD3 －CD19 ＋B细胞、自然杀伤(natural killer，NK)细胞绝对计数差异均有统计学意义( H＝20.77、55.58， P值均<0.05)。其中，与血管炎患者相比，抗磷脂综合征、强直性脊柱炎AID患者CD3 －CD19 ＋B细胞绝对计数显著升高( P＝ 0.004、0.022 )；与系统性红斑狼疮患者相比，血管炎、类风湿性关节炎、抗磷脂综合征患者CD3 －CD16 ＋CD56 ＋NK细胞绝对计数显著升高( P＝0.001、0.001、0.001 )；与干燥综合征患者相比，血管炎、抗磷脂综合征患者CD3 －CD16 ＋CD56 ＋NK细胞绝对计数显著升高( P＝0.028、0.001)。 结论:AID患者淋巴细胞亚群绝对计数较健康对照组明显降低，且淋巴细胞数量的具体增高或降低及变化的幅度因罹患AID的类型不同而有所差异。

abstractsObjective:To investigate the number and differences of peripheral lymphocyte subsets in patients with different types of autoimmune diseases(AID).Methods:Total of 147 patients with AID admitted to the Second Affiliated Hospital of the Air Force Medical University from January 2023 to August 2023 were enrolled as the AID group. According to the etiology, the AID group was divided into vasculitis group (19 cases), Sjogren's syndrome group (13 cases), rheumatoid arthritis group (20 cases), ankylosing spondylitis group (5 cases), systemic lupus erythematosus group (74 cases), systemic sclerosis group (8 cases), and antiphospholipid syndrome group (8 cases). Forty-two healthy volunteer specimens submitted for testing at the same time were selected as the control group. Flow cytometry was used to detect the number of peripheral blood lymphocyte subsets.Results:Compared with the control group, the absolute total T cell counts(CD3 + ), the absolute helper T cell counts (CD3 + CD4 + ), the absolute inhibitory T cell counts (CD3 + CD8 + ), the absolute B cell counts (CD3 -CD19 + ) and the absolute NK cell counts (CD3 -CD16 + CD56 + ) in the AID group were significantly lower than those in the control group ( Z=- 7.00, -4.34, -2.62, -4.77, -6.51, all P values <0.05). The statistically significant differences have been found in T lymphocytes CD3 +, CD3 + CD4 + and CD3 + CD8 + lymphocytes among the subgroups of AID patients ( H =19.86, 28.66, 12.66, all P values <0.05). Among them, Compared with patients of systemic lupus erythematosus, the absolute count of CD3 + T and CD3 + CD4 + T lymphocytes in patients with antiphospholipid syndrome were significantly increased, and the absolute counts of CD3 + CD4 + T lymphocytes in patients with ankylosing spondylitis were significantly increased ( P= 0.012, 0.002, 0.038 ). There were statistically significant differences in B lymphocytes and natural killer(NK) cells among different types of AID patients ( H=20.77, 55.58, both P values <0.05). Among them, the absolute count of CD3 -CD19 + B lymphocytes in the patients with antiphospholipid syndrome and ankylosing spondylitis were significantly higher compared with vasculitis patients ( P=0.004, 0.022 ). The absolute count of CD3 -CD16 + CD56 + NK cells in patients with vasculitis, rheumatoid arthritis and antiphospholipid syndrome were significantly higher compared with systemic lupus erythematosus patients ( P=0.001, 0.001, 0.001), and the absolute count of CD3 -CD16 + CD56 + NK cells in patients with vasculitis and antiphospholipid syndrome were significantly higher compared with Sj?gren's syndrome patients ( P= 0.028, 0.001 ). Conclusion:The absolute count of lymphocyte subsets in AID patients were significantly reduced compared to the healthy control group, and the specific increase or decrease and the magnitude of change varied depending on the type of AID.