系统性红斑狼疮中医证型与T淋巴细胞亚群及免疫学指标的相关性OA

Objective It is to explore the differences and correlations of T lymphocyte subsets and immunological indi-cators in patients with systemic lupus erythematosus(SLE)of different TCM syndrome types,and to provide objective labo-ratory indicators for reference in the TCM syndrome differentiation and classification of SLE.Methods A total of 140 SLE patients hospitalized in the Department of Rheumatology of the Affiliated People's Hospital of Fujian University of Tradi-tional Chinese Medicine from November 2022 to May 2025 were included.According to the TCM syndrome differentiation and classification,the patients were divided into heat-toxin intense group(group A),blood stasis with heat and toxin accu-mulation group(group B),turbid toxin obstruction group(group C),heat-toxin burning Yin group(group D),liver de-pression and toxin accumulation group(group E),and healthy Qi deficiency with lingering pathogenic factors group(group F),then the patients were divided into excess syndrome group and deficiency syndrome group based on the diagnostic crite-ria of excess syndrome and deficiency syndrome of TCM.The percentages and absolute counts of T lymphocyte subsets(CD3+,CD4+,CD8+)in peripheral blood,immunological indicators[IgA,IgG,IgM,complement C3,complement C4]and SLEDAI scores of each group were compared,the relationships between T lymphocyte subsets,immunological in-dicators,SLEDAI scores and excess and deficiency syndromes of TCM,as well as their value for diagnosing excess and de-ficiency syndromes were analyzed.Results There were no statistically significant differences in the percentages of CD3+,CD4+,CD8+and the levels of IgA,IgM and complement C4 among each group(all P>0.05);the absolute counts of CD3+and CD8+in group A were significantly lower than those in the other groups(all P<0.05),while the absolute counts of CD3+and CD8+in group F were significantly higher than those in group B,group E,group C and group D(all P<0.05);the absolute count of CD4+in group A was significantly lower than that in group C,group D and group F(all P<0.05),while the absolute count of CD4+in group F was significantly higher than that in group B,group C and group E(all P<0.05).The level of IgG in group A and that of IgG and complement C3 in group F were significantly higher than those in group C(all P<0.05);the SLEDAI score in group A was significantly higher than that in group B,group D and group F(all P<0.05),the SLEDAI score in group F was significantly lower than that in group B,group C and group E(all P<0.05),and the SLEDAI score in group D was significantly lower than that in group C and group E(all P<0.05).The absolute counts of CD3+,CD4+and CD8+in the excess syndrome group were all lower,and the SLEDAI score than those in the deficiency syndrome group(all P<0.05).Univariate Logistic regression analysis showed that the decreases of absolute counts of CD3+,CD4+and CD8+,as well as the increase of SLEDAI score were the risk factors for TCM excess syndrome in SLE.Multivariate Logistic regression analysis showed that the absolute count of CD3+and SLE-DAI score were independently correlated with excess and deficiency syndromes of TCM(all P<0.05).The AUC of the combination of absolute counts of CD3+,CD4+,CD8+and SLEDAI score for diagnosing the excess and deficiency syn-drome of TCM in SLE was 0.742,the sensitivity was 0.566,and the specificity was 0.812.Conclusion There are differ-ences in T lymphocyte subsets and immunological indicators among SLE patients with different TCM syndrome types,T lym-phocyte subsets,immunological indicators and SLEDAI score are related to TCM syndrome types and can be used as refer-ence indicators for TCM syndrome differentiation of SLE;the combination of T lymphocyte subsets and SLEDAI score has a better efficacy in diagnosing the excess and deficiency syndromes of TCM in SLE.