Objective To investigate the expression and significance of Th17 and Treg cells in the peripheral blood of patients with systemic lupus erythematosus (SLE)and lupus nephritis (LN), so as to explore for noninvasive biomarker in evaluation of disease severity. Methods The percentage of Th17 and Treg cells in the peripheral blood of 103 patients with SLE (including 40 SLE patients with lupus nephritis) and 23 healthy volunteers were detected by flow cytometry. The disease activity of SLE was measured by SLEDAI.SLE patients were divided into four groups:in-active SLE (SLEDAI 0-4, n=16), mild active SLE (SLEDAI 5-9, n=29), moderate active SLE (SLEDAI 10-14, n=26) and severe active SLE (SLEDAI≥15, n=32). The correlations between the expression of Th17, Treg cells, SLEDAI, and LN in SLE patients and healthy controls were analyzed respectively . Results ①The percentage of Th17 in the peripheral blood in patients with mild, moderate and severe active SLE was higher than those in normal controls and inactive SLE (P<0.05). The percentages of peripheral blood Th17 in patients with moderate and severe active SLE were higher than that in inactive SLE (P<0.05). The percentage of peripheral blood Th17 in patients with LN was higher than that in non-LN patients (P<0.05). The percentage of peripheral blood Th17 in SLE patients with reduced levels of complements was higher than those in SLE patients with normal levels of complements SLE and in controls (P<0.05). The percentage of Th17 was positively correlated with disease activity ( P<0.05). ②The percentage of pe-ripheral blood Treg in patients with moderate and severe active SLE was lower than those in normal controls and in-active SLE (P<0.05). The percentage of peripheral blood Treg in patients with severe active SLE was lower than that in mild active SLE (P<0.05). The percentage of peripheral blood Treg in SLE patients with reduced levels of comple-ments was lower than those in SLE patients with normal levels of complements and in controls ( P<0.05). ③The ratio of Th17/Treg in patients with mild, moderate and severe active SLE was higher than those in normal controls and in-active SLE (P<0.05). The ratio of Th17/Treg in patients with moderate and severe active SLE was higher than that in mild SLE (P<0.05). The ratio of Th17/Treg in patients with LN was higher than that in non-LN patients (P<0.05). The ratio of Th17/Treg in SLE patients with reduced levels of complements was higher than those in SLE patients with nor-mal levels of complements and in controls (P<0.05). The ratio of Th17 was positively correlated with disease activity (P<0.05). Conclusion There is an abnormal elevation of Th17 cells, decrease of Treg cells and aberrant ratio of Th17/Treg that are correlated with disease severity, suggesting the imbalance between Th17 and Treg cells, in addition to the changes in Th17 and Treg levels, may play a critical role in the pathogenesis of SLE .%目的：探讨Th17细胞和调节性T细胞在系统性红斑狼疮（SLE）、狼疮肾炎（LN）发生和发展中的作用，以期寻找病情评估的无创性新指标。方法选取SLE患者103例及23名健康体检者，其中LN患者40例，新诊断、未治疗的SLE患者42例。SLE患者非活动组（SLEDAI 0～4分）患者16例、轻度活动组（SLEDAI 5～9分）患者29例、中度活动组（SLEDAI 10～14分）患者26例、重度活动组（SLEDAI≥15分）患者32例。用四色分选流式细胞仪检测外周血CD4＋IL-17＋Th17细胞和CD4＋CD25＋FOXP3＋Treg细胞百分数，分析其与疾病活动性（SLEDAI评分）、补体C3、C4和肾脏受累的关系。结果①SLE轻度、中度、重度活动组Th17细胞百分数均高于健康对照组和SLE非活动组，差异均有统计学意义（P＜0．05）；SLE中度、重度活动组Th17细胞均高于SLE轻度活动组，差异均有统计学意义（P＜0．05）；LN组Th17细胞高于非LN组，差异有统计学意义（P＜0．05）；新发SLE活动组Th17细胞百分数高于健康对照组和SLE非活动组，差异均有统计学意义（P＜0．05）。补体降低组SLE患者Th17细胞高于补体正常组及健康对照组，差异均有统计学意义（P＜0．05）。Th17细胞百分数与SLEDAI评分呈正相关。②SLE中度、重度活动组Treg细胞百分数均低于健康对照组和SLE非活动组，差异均有统计学意义（P＜0．05）；SLE重度活动组Treg细胞低于SLE轻度活动组，差异有统计学意义（P＜0．05）。LN组Treg细胞与非LN组差异无统计学意义。新发SLE活动组Treg细胞百分数低于健康对照组和SLE非活动组，差异均有统计学意义（P＜0．05）。补体降低组SLE患者Treg细胞低于补体正常组及健康对照组，差异均有统计学意义（P＜0．05）。Treg细胞百分数与SLEDAI评分无相关性。③SLE轻度、中度、重度活动组Th17/Treg比值均高于健康对照组和SLE非活动组，差异均有统计学意义（P＜0．05）；SLE中度、重度活动组Th17/Treg比值均高于SLE轻度活动组，差异均有统计学意义（P＜0．05）；LN组Th17/Treg高于非LN组，差异有统计学意义（P＜0．05）。新发SLE活动组Th17/Treg细胞比值高于健康对照组和SLE非活动组，差异均有统计学意义（P＜0．05）。补体降低组SLE患者Th17/Treg比值高于补体正常组及健康对照组，差异均有统计学意义（P＜0．05）。Th17/Treg比值与SLEDAI评分呈正相关。结论活动性SLE患者外周血Th17细胞升高、Treg细胞下降，Th17/Treg细胞比值与疾病活动呈正相关，提示SLE发病不仅仅是Th17细胞升高或Treg细胞下降，而是二者相互作用导致免疫失衡导致。
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