Objective To investigate the relationship between the levels of programmed death ligand 1 (PD-L1) on circulating B cells and disease severity as well as renal injury of patients with systemic lupus erythematosus (SLE) .Methods 50patients with SLE were enrolled from May 2015to May 2017, and 20healthy individuals were enrolled as the control group.All patients were scored for their disease severity and renal injury.The expression of PD-L1on circulating B cells were evaluated by flow cytometery.Results In the group of patients with active SLE, the percentage of CD19+in B cells was (11.35±3.65) ％and the percentage of in CD19+B cells was (2.47±0.89) ％, both of which were significantly higher than that in the group of patients with non-active SLE and control group (P<0.05) .In addition, patients with SLE were divided into lower group and higher group according to the median percentage of CD19+and CD19+/PD-L1Bcells.The incidence of kidney lesion was robustly increased in the high group, and CD19+/PD-L1Bcells, LNⅣwere independent risk factors of renal insufficiency in lupus nephritis.Conclusion The level of peripheral CD19+/PD-L1in SLE patients increased significantly and was closely related to the activity degree and renal injury of the disease, which was an independent risk factor for renal insufficiency in patients.%目的 探讨系统性红斑狼疮 (SLE) 患者外周血中B细胞表达程序性死亡分子配体1 (PD-L1) 的水平与狼疮病情活动程度及肾脏损伤程度的关系.方法 选择2015年5月至2017年5月期间50例在该院诊断为SLE的患者作为研究对象, 并以20例健康体检人群为对照组, 所有患者均进行狼疮活动度评分, 采用流式细胞仪检测B细胞中PD-L1表达水平, 探讨SLE患者B细胞PD-L1与患者病情活动评分及肾脏损伤的关系.结果 SLE活动期患者CD19+占B细胞总数的比例为 (11.35±3.65) ％, PD-L1在CD19+B细胞表达的阳性率为 (2.47±0.89) ％, 明显高于非活动期患者及对照组, 差异有统计学意义 (P<0.05);根据CD19+和CD19+/PD-L1的中位数水平将患者分为低水平和高水平组, CD19+高水平和CD19+/PD-L1高水平的患者肾损伤的发生率明显更高, CD19+/PD-L1、狼疮性肾炎 (LN) Ⅳ期是患者肾功能不全发生的独立危险因素.结论SLE患者外周CD19+/PD-L1的水平显著增加并与疾病的活动程度及肾脏损伤密切相关, 是患者肾功能不全的独立危险因素.
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