涂建欣　朱小春　孙　莉温州医科大学附属第一医院风湿免疫科，浙江温州　325000

EB病毒对系统性红斑狼疮患者临床表现及Th1/Th2平衡的影响

涂建欣朱小春孙莉
温州医科大学附属第一医院风湿免疫科，浙江温州325000

目的探讨EBV对SLE患者临床表现及Th1/Th2平衡的影响。方法选择2013年1月～2015年12月在我院治疗的系统性红斑狼疮患者171例为研究组，另选择在我院进行健康体检者60例为对照组。SLE患者根据EBV-DNA结果分为EBV阳性亚组和EBV阴性亚组。分析EBV感染对患者临床表现的影响及对Th1/Th2平衡的影响。结果SLE患者EBV-DNA阳性率显著高于对照组，差异有统计学意义（P＜0.05）。EBV阳性亚组SLE患者皮疹、关节炎、血液系统受累发生率、抗Rib-P抗体、抗Smith抗体阳性率及高免疫球蛋白血症发生率显著高于EBV阴性亚组，差异有高度统计学意义（P＜0.01）。SLE患者EBV阳性亚组与阴性亚组及对照组Th2水平及Th1/ Th2水平，IL-4水平比较，差异有高度统计学意义（P＜0.01）。结论EBV感染可能通过影响Th1/Th2平衡参与SLE发生发展，并与SLE患者皮疹、关节炎和血液系统损害有关。

EB病毒；系统性红斑狼疮；Th1；Th2

［Abstract］Objective To explore the effects of EBV on clinicalmanifestation of patients with systemic lupus erythematosus（SLE）and Th1/Th2 balance.M ethods 171 patients with SLE who were treated in our hospital from January 2013 to December 2015 were selected as research group，and another 60 healthy subjects who were given physical examination in our hospital were selected as control group.The patients with SLE were divided into EBV positive subgroup and EBV negative sub-group according to the results of EBV-DNA.The effect of EBV infection on clinicalmanifestation in patients and its effect on Th1/Th2 balance were analyzed.Results Positive rate of EBV-DNA in SLE patients were significantly higher than that in the control group，and the difference was statistically significant（P＜0.05）. Incidence rate of skin rash，arthritis，and involvementof hematological system，positive rate of anti-Rib-P antibody and anti-Smith antibody and incidence rate of hyperimmunoglobulinemia in EBV positive sub-group of SLE patients were significantly higher than those in EBV negative sub-group，and the differences were statistically significant（P＜0.01）. Th2 level，Th1/Th2 level and IL-4 level were compared between EBV positive sub-group，negative sub-group of SLE patients and control group，and the differences were statistically significant（P＜0.01）.Conclusion EBV infection may participate in the occurrence and development of SLE via its effect on Th1/Th2 balance，and is associated with skin rash，arthritis and hematological system impairment in SLE patients.

［Key words］EB virus；Systemic lupus erythematosus（SLE）；Th1；Th2

系统性红斑狼疮是风湿免疫科的常见病、多发病，目前其发病机制还不十分明确，是一种自身免疫性疾病，病情迁延，表现复杂，目前认为其与感染、激素、遗传等因素有关［1，2］。其中EB病毒（epstein-barr viruses，EBV）感染与系统性红斑狼疮的关系备受关注，但具体机制还不明确［3］。研究显示系统性红斑狼疮（systemic lupus erythematosus，SLE）患者存在Th1/Th2失衡，Th1/Th2失衡是其发病机制之一［4］。本研究主要探讨EB感染是否对系统性红斑狼疮的Th1/Th2平衡及临床表现产生影响，现报道如下。……