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    血清炎性因子与系统性红斑狼疮疾病活动度、体液免疫的相关性及其诊断价值

    Correlation of serum inflammatory factors with systemic lupus erythematosus disease activity, humoral immunity and its diagnostic value

      摘要
    • 摘要: 目的：分析系统性红斑狼疮（SLE）患者血清炎性因子水平及与疾病活动度、体液免疫功能的相关性，并评估血清炎性因子对SLE的诊断价值。方法：选取2019年5月至2021年12月就诊于本院的80例SLE患者（SLE组），按照SLE病情活动程度评分（SLEDAI）将患者分为活动期组、非活动期组。另选择同期80例健康体检者作为对照组。检测血清白介素（IL）-6、IL-10、肿瘤坏死因子（TNF）-α、C反应蛋白（CRP）、干扰素（IFN）-γ水平。采用受试者工作特征（ROC）曲线分析血清炎性因子对SLE 发生的诊断价值，Pearson 相关性分析法分析血清炎性因子与免疫球蛋白、SLEDAI 评分的相关性。结果：SLE 组血清CRP、IL-6、IL-10、IFN-γ 和TNF-α 水平高于对照组，且活动期血清炎症因子及IgA、IgM、IgG 水平高于非活动期组（均P< 0.001）。血清CRP、IL-6、IL-10、IFN-γ、TNF-α 及以上指标联合诊断SLE 的AUC 分别为0.719（95%CI：0.624～0.815）、0.879（95% CI：0.816～0.943）、0.699（95% CI：0.606～0.792）、0.852（95% CI：0.782～0.923）、0.816（95% CI：0.728～0.905）、0.962（95%CI：0.931～0.992）。二元logistic回归分析显示，血清CRP、IL-6、IL-10、IFN-γ和TNF-α水平均为SLE发生的危险因素（均P< 0.001）。Pearson 相关分析显示，血清CRP、IL-6、IL-10、IFN-γ、TNF-α 均与IgA、IgM、IgG、SLEDAI 评分呈正相关关系（均P< 0.001）。结论：SLE患者血清炎性因子水平升高，与患者体液免疫功能、疾病活动度有关，且联合检测可有效诊断SLE的发生。

       

      Abstract: Objective:To analyze the correlation between serum inflammatory factors and disease activity and humoral immune function in patients with systemic lupus erythematosus (SLE), and to evaluate the diagnostic value of serum inflammatory factors in SLE.Methods:A total of 80 SLE patients admitted to Shanghai Tongren Hospital from May 2019 to December 2021 were selected as SLE group.According to the SLE disease activity score (SLEDAI), the patients were divided into active group and inactive group.Another 80 healthy subjects during the same period were selected as healthy group.The serum levels of interleukin-6(IL-6), interleukin-10(IL-10), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and interferon-γ (IFN-γ) were detected.The receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of serum inflammatory factors for SLE.The correlation between serum inflammatory factors and immunoglobulin and SLEDAI score was analyzed by Pearson correlation.Results:Serum CRP, IL-6, IL-10, IFN-γ and TNF-α levels in the SLE group were higher than those in the healthy group and the levels of serum inflammatory factors, IgA, IgM and IgG in the active SLE group were higher than those in the inactive SLE group(all P< 0.001).The AUC of serum CRP, IL-6, IL-10, IFN-γ, TNF-α and their combination in the diagnosis of SLE were 0.719 (95% CI:0.624-0.815), 0.879 (95% CI: 0.816-0.943), 0.699(95% CI: 0.606-0.792), 0.852(95% CI:0.782-0.923), 0.816 (95% CI: 0.728-0.905) and 0.962 (95% CI: 0.931-0.992), respectively.The binary logistic regression analysis found that serum CRP, IL-6, IL-10, IFN-γ and TNF-α levels were risk factors for SLE (all P< 0.001).Pearson correlation showed that serum CRP, IL-6, IL-10, IFN-γ and TNF-α were positively correlated with IgA, IgM, IgG and SLEDAI scores (all P< 0.001).Conclusion:Serum levels of inflammatory factors in SLE patients increase, which is related to humoral immune function and disease activity, and combined detection can effectively diagnose the occurrence of SLE.

       

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