Changes and clinical significance of peripheral blood T lymphocyte subsets in systemic lupus erythematosus patients complicated with pulmonary hypertension
Objective:To investigate the changes and clinical significance between the peripheral blood T lymphocyte subsets in systemic lupus erythematosus(SLE) patients with pulmonary hypertension(PH).Methods:A total of 121 active SLE patients diagnosed in Affiliated Hospital of Jining Medical University from January 2020 to January 2023 were selected as the research objects into PH group (n=57) and non-PH group (n=64). The general data and T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+ /CD8+ ) in the 2 groups were detected and compared. The correlation between T lymphocyte subsets and pulmonary artery systolic pressure in SLE patients were analyzed by Spearman′s correlation coefficient, and binary Logistic regression was used to analyse the factors influencing SLE-PH. Receiver operating characteristic(ROC) curve analysis was performed to analyze the predictive value of relevant indicators in these patients.Results:The general data of PH and non-PH group, such as age, sex, course of disease, BMI and SLEDAI score had no statistically significant difference (all P>0.05). CD3+ T lymphocyte level[79.88(71.31, 86.60)%, 75.24(66.19, 81.60)%] and CD8+ T lymphocyte level[44.61(32.02, 59.61)%, 33.17(26.57, 40.42)%] were higher in the PH group than those in the non-PH group. CD4+ T lymphocyte level[31.33(21.25, 41.50)%, 40.03(29.95, 51.26)%], CD4+ /CD8+ [0.67(0.45, 1.17), 1.25(0.84, 1.67)] in the PH group were lower than those in the non-PH group, and the differences were statistically significant (Z=1.99, 3.73, 3.15, 4.03, all P<0.05). Spearman correlation analysis showed that the pulmonary artery systolic pressure in SLE patients was negatively correlated with CD4+ T lymphocyte level (r=-0.297, P<0.01) and CD4+ /CD8+ level(r=-0.357, P<0.05), and positively correlated with CD8+ T lymphocyte level (r=0.316, P<0.01). Binary Logistic regression analysis showed that high CD8+ T lymphocyte level (OR=1.108, P<0.01] was the risk factor for developing PH, and high CD4+ T lymphocyte level (OR=0.092, P<0.01) was the protective factor for developing PH. The ROC curve results showed that the AUCs for CD3+, CD4+, CD8+ T lymphocyte level, CD4+ /CD8+ and the combined test predicted SLE combined with PH were 0.605, 0.666, 0.697, 0.713 and 0.794, respectively, all had good predictive efficacy (all P<0.05), and the combined prediction efficiency was higher than that of single detection.Conclusions:Abnormal levels of peripheral blood T lymphocyte subsets are associated with SLE combined with PH, which hold significant value for the evaluation of the disease. It can serve as an important reference index, and offer substantial guidance for clinical diagnosis and treatment and disease prognosis prediction.
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