关键词: 狼疮肾炎, CD4阳性T淋巴细胞, 感染

Abstract: Objective  To detect and evaluate the clinical value of dynamic monitoring of  CD4+T lymphocyte count in the treatment of  patients with lupus nephritis (LN). Methods  38 patients with newly diagnosed LN who had measured CD4+ T lymphocyte count at initial diagnosis and after induction therapy were selected  as our study subjects.The CD4+ T lymphocyte count at the time of initial diagnosis, after induction therapy and during maintenance therapy  were monitored.Among them, 20 cases improved the third CD4+ T lymphocyte count during maintenance therapy. The relationship between CD4+T lymphocyte count and clinical, immune indicators and  clinical infection  events in each treatment stage  was analyzed. Results The decrease of CD4+T lymphocyte count at initial diagnosis  was negatively correlated with the activity of systemic lupus erythematosus (SLE) (P=0.023). However, the relapse of CD4+T lymphocyte count reductions  during maintenance of therapy was associated with immunosuppression and high infection rate (70%). Further statistical analysis CD4+T lymphocyte count indicates shows that the area under the ROC curve (AUC) was 0.833, which reflect the prediction of infection.The sensitivity and specificity of the prediction of infection were 83.3%  and  85.7% respectively. In LN patients during maintenance treatment, 56.2% of the infections occurred within 6 months after their induction therapy. Pulmonary infection was the most common. Conclusion  The decrease of CD4+T lymphocyte count in LN patients at initial diagnosis is associated with SLE activity. For the LN patients at the maintenance therapy stage, especially in 6 months after their induction therapy, the renewed decrease of CD4+T lymphocyte count should be highly valued as a signal of infection occurrence.

Key words: lupus nephritis, CD4Positive TLymphocytes, infection