| Objective:1.The differences of peripheral blood lymphocyte subsets in patients with polymyositis/dermatomyositis(polymyositis/dermatomyositis,PM/DM)were compared with those in healthy controls.2.To analyze the correlation between peripheral lymphocytes and disease activity in patients with polymyositis/dermatomyositis.3.To observe the effect of low-dose IL-2 combined therapy on peripheral blood lymphocyte subsets in patients with polymyositis/dermatomyositis.4.To compare the efficacy and safety of low-dose IL-2 combination regimen and traditional therapy regimen in the treatment of polymyositis/dermatomyositis.Methods:1.A total of 147 PM/DM patients were selected as the study group and 128 healthy persons as the control group.The general clinical data of all subjects,such as age,sex,course of disease,blood routine,liver and kidney function,were collected and recorded.At the same time,the VAS score and erythrocyte sedimentation rate(erythrocyte sedimentation rate,ESR)of the patients with polymyositis/dermatomyositis were collected.2.One hundred and sixteen patients with PM/DM treated with traditional therapy such as hormone and immunosuppressant were used as the traditional treatment group,and on the basis of the traditional treatment,Thirty-one patients treated with low-dose recombinant human IL-2(50WIU/subcutaneously injected once a day for 5 days)were treated as IL-2 treatment group.3.The absolute counts of lymphocytes in peripheral blood of all healthy subjects and PM/DM patients before treatment were detected and recorded by improved flow cytometry.To analyze the possible relationship between peripheral lymphocyte subsets and the incidence of PM/DM and the correlation between peripheral lymphocyte subsets and disease activity.4.To compare the changes of VAS score and ESR disease activity index before and after treatment between traditional therapy group and low-dose IL-2 treatment group,and to compare the change of lymphocyte subsets before and after traditional therapy combined with low-dose IL-2 treatment.To evaluate the clinical efficacy of the two treatments and the effect of IL-2 on peripheral lymphocytes in patients with polymyositis/dermatomyositis.5.The blood routine,liver function and renal function were compared before and after treatment in two groups of patients with different treatment regimens,and the adverse reactions of patients in the course of using combined low-dose IL-2 were recorded at the same time.To evaluate and compare the safety of the two treatments.Results:1.A total of 147 patients with PM/DM were included in the observation group,including41 males and 106 females,with an average age of(52.2±14.5)years.There were 128healthy controls,41 males and 87 females,with an average age of(48.89±9.87)years(30±70 years).There was no significant difference in sex ratio and age between the two groups(P>0.05).2.The absolute counts of T cells,NK cells,CD4~+T cells,CD8~+T cells,Th1 cells,Th2cells,Th17 cells and Treg cells in PM/DM patients were significantly lower than those in healthy controls(P<0.05).3.The scores of VAS and ESR were negatively correlated with the absolute counts of peripheral lymphocytes in patients with PM/DM,including T cells,B cells,CD4~+T cells,CD8~+T cells,Th1 cells,Th2 cells,Th17 cells and Treg cells(P<0.05).4.A total of 116 patients with PM/DM were treated with traditional hormone and immunosuppressive agents and were included in the traditional treatment group.There were 32 males and 84 females aged 11 to 78 years in this group.Thirty-one patients were treated with low-dose IL-2 for 5 days on the basis of traditional treatment,and were included in the IL-2 treatment group.In this group,there were 9 males and 22 females,aged 21 to 78 years.There was no significant difference in sex and age between the two groups(P>0.05).5.There was no significant difference in VAS score between the two groups before treatment(P>0.05),compared with the traditional treatment group.Compared with pre-treatment,the scores of VAS and ESR in both groups decreased significantly(P<0.01),and the degree of decrease in VAS scores in patients treated with IL-2 was more significant(P<0.05)after treatment with IL-2 than that before treatment(P<0.05),and the scores of VAS in patients treated with IL-2 were significantly lower than those before treatment(P<0.05).6.The serum alanine aminotransferase,aspartate aminotransferase,urea nitrogen and creatinine in the IL-2 combined treatment group were still within the normal range,although there was no significant difference between the two groups before and after the routine administration of the drugs,but the levels of alanine aminotransferase,aspartate aminotransferase,urea nitrogen and creatinine in the combined treatment group were still within the normal range.There was no significant difference between the two groups(P>0.05).Conclusion:1.Autoimmune dysfunction existed in patients with polymyositis/dermatomyositis,the main manifestation of which was the decrease of absolute counts of peripheral lymphocyte subsets.2.Peripheral lymphocyte subsets were associated with disease activity in patients with polymyositis/dermatomyositis.3.Combined use of low-dose IL-2 can improve the patient’s condition more effectively than traditional immunosuppressive therapy,but also can restore the autoimmune tolerance of patients with polymyositis/dermatomyositis to a certain extent.4.Combined use of low-dose IL-2 can improve the patient’s condition safely and effectively. |
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