方法：选取2018-04/2020-05本院确诊收治的JIA-U患儿95例作为JIA-U组； 70例JIA患儿作为JIA组； 另选同时期正常健康体检儿童75例作为对照组。流式细胞仪检测外周血中CDld^(hi)CD5⁺CD19⁺Breg比例； ELISA法检测外周血中IL-10水平； 采用Pearson相关系数法分析CD1d^(hi)CD5⁺CD19⁺Breg比例与IL-10表达及JIA-U患者病情严重程度的相关性； Logistic回归分析影响JIA-U发生的因素。

结果：与对照组相比，JIA组、JIA-U组患儿外周血中CD1d^(hi)CD5⁺CD19⁺Breg比例显著降低(均P<0.01)，而IL-10水平显著增加(均P<0.01)； 与JIA组相比，JIA-U组CD1d^(hi)CD5⁺CD19⁺Breg比例显著降低(P<0.01)，而IL-10水平显著增加(P<0.01)； 与静止期相比，活动期JIA及JIA-U患者CD1d^(hi)CD5⁺CD19⁺ Breg比例显著降低(均P<0.01)，IL-10水平显著增加(均P<0.01)。CD1d^(hi)CD5⁺CD19⁺Breg比例与IL-10表达及JIA-U患者病情严重程度呈显著负相关。多因素分析发现，CD1d^(hi)CD5⁺CD19⁺Breg低比例、JIA亚型为少关节型、关节炎病程<4a、IL-10高水平均是影响JIA-U发生的危险因素。

结论：CDld^(hi)CD5⁺CD19⁺Breg在JIA-U患儿外周血中比例显著降低，其可能参与JIA-U的发生发展，有作为JIA-U疾病严重程度判断指标的潜能。

METHODS: From April 2018 to May 2020, 95 children with JIA-U were selected as JIA-U group; 70 children with juvenile idiopathic arthritis(JIA)were selected as JIA group, and all of them were diagnosed and treated in our hospital; another 75 healthy children in the same period were selected as the control group. The ratio of CDld^(hi)CD5⁺CD19⁺Breg in peripheral blood was detected by flow cytometry; the level of IL-10 in peripheral blood was detected by ELISA; the correlation between CDld^(hi)CD5⁺CD19⁺Breg ratio and the expression of IL-10, the severity of JIA-U patients was analyzed by Pearson correlation coefficient method; the influencing factors of JIA-U were analyzed by Logistic regression.

RESULTS: Compared with the control group, the proportion of CDld^(hi)CD5⁺CD19⁺Breg in peripheral blood of children in JIA group and JIA-U group was significantly lower(all P<0.01), while the level of IL-10 was significantly higher(all P<0.01); compared with JIA group, the proportion of CDld^(hi)CD5⁺CD19^+Breg in JIA-U group was significantly lower(P<0.01), while the level of IL-10 was significantly higher(P<0.01); compared with the stationary phase, the ratio of CD1d^(hi)CD5⁺CD19⁺Breg in the active phase of JIA and JIA-U patients was significantly reduced(all P<0.01), and the IL-10 level was significantly increased(all P<0.01); the ratio of CDld^(hi)CD5⁺CD19⁺Breg was negatively correlated with the expression of IL-10 and the severity of JIA-U; multivariate analysis showed that low proportion of CDld^(hi)CD5⁺CD19⁺Breg, less-joint JIA subtype, duration of arthritis < 4a, high levels of IL-10 were risk factors for JIA-U.

CONCLUSION: The proportion of CDld^(hi)CD5⁺CD19⁺Breg in peripheral blood of children with JIA-U is significantly decreased, which may be involved in the occurrence and development of JIA-U, and has the potential to be used as an index to judge the severity of JIA-U.