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目的探讨 CD40及其配体（ CD40L）在系统性红斑狼疮（ SLE）发病机制中的作用及临床意义。方法应用逆转录－聚合酶链反应（ RT-PCR）检测 34例 SLE患者外周血单一核细胞（ PBMC）中 CD40和 CD40配体 mRNA的表达水平。结果活动期 SLE患者 PBMC中 CD40配体的阳性表达率为 88.24％（ 30/34），明显高于正常人对照组（ 50.00％， 15/30），差异有非常显著性（ P< 0.01）；活动期 SLE患者 PBMC中 CD40配体 mRNA表达的平均水平（ 0.6970± 0.1214）亦明显高于正常人对照组（ 0.2684± 0.0795），差异有非常显著性 (P< 0.01)。活动期 SLE患者 PBMC中 CD40的阳性表达率和 CD40 mRNA的表达水平与对照组相比差异均无显著性（ P >0.05）。结论 CD40配体的异常表达可能在 SLE疾病活动和发展过程中起重要作用，检测 SLE患者 PBMC中 CD40配体的表达水平可作为疾病的活动性指标之一。
Objective To investigate the role of CD40 and its ligand (CD40L) in the pathogenesis of systemic lupus erythematosus (SLE) and its clinical significance. Methods The expression of CD40 and CD40 ligand mRNA in peripheral blood mononuclear cells (PBMCs) from 34 patients with SLE was detected by reverse transcription polymerase chain reaction (RT-PCR). Results The positive rate of CD40 ligand in PBMC of patients with active SLE was 88.24% (30/34), which was significantly higher than that of control group (50.00%, 15/30). The difference was significant (P <0.01). The average level of CD40 ligand mRNA expression in PBMC of active SLE patients (0.6970 ± 0.1214) was also significantly higher than that of normal controls (0.2684 ± 0.0795), the difference was significant (P <0.01). The positive expression rate of CD40 and the expression of CD40 mRNA in PBMC of active SLE patients were not significantly different from those in control group (P> 0.05). Conclusion Aberrant expression of CD40 ligand may play an important role in the pathogenesis and progression of SLE. Detection of CD40 ligand expression in PBMC of SLE patients may be one of the active markers of disease.