血清B因子水平与系统性红斑狼疮病情活动相关性研究

The role and significance of serum B factor in the pathogenesis of systemic lupus erythematosus

目的 测定系统性红斑狼疮（SLE）患者血清中B因子水平,探讨B因子在SLE中的临床意义及其与病情活动性的关系.方法 78例SLE患者和46例健康体检者纳入本研究.用散浊比色法检测78例SLE患者及46例健康对照者血清B因子水平,按照系统性红斑狼疮疾病活动性指数（SLEDAI）评分标准,将SLE患者分为SLE活动组和SLE稳定组,分析SLE患者与健康对照组间B因子水平的差异,以及不同严重程度的SLE患者间的B因子水平差异;比较SLE活动组与SLE稳定组间B因子水平和其他实验和临床指标的差异,同时对B因子与其他实验室和临床指标的相关性进行分析.结果 SLE组血清B因子水平明显低于健康对照组[（27.13±8.98） mg/dl vs（36.73±5.47） mg/dl,t=7.4,P＜0.01],SLE组中病情活动组B因子水平明显低于病情稳定组[（21.70±7.41） mg/dl vs（35.80±8.89） mg/dl,t=7.63,P＜0.01],SLE组B因子与C3、C4呈正相关（P＜0.01）,与CRP、SLEDAI评分呈负相关（P＜0.01）,而与白细胞、血红蛋白、血小板、ESR等无明显相关性.结论 SLE患者BF水平降低,可能参与SLE发病机制,检测BF水平对SLE的诊断及疾病的活动性判断具有一定的意义.

Objective To investigate the expression of serum B factor in the peripheral blood of patients with systemic lupus erythematosus （SLE）,and explore its role in the pathogenesis.Methods Seventy eight patients with SLE in our hospital and 46 healthy persons were eligible to participate in this study.Rate nphelometyr was used to test serum B factor for 78 patients with SLE and 46 healthy controls.According to systemic lupus erythematosus disease activity index （SLEDAI）,participants were divided into steady SLE group （SLEDAI 〈 5） and active SLE group （SLEDAI ≥5）,which was further divided into mild,moderate,and serious subgroups.The differences in serum B factor between SLE patients and healthy controls,including SLE patients with different severity,were all compared.Then we analyzed the differences in serum B factor and other laboratory and clinical indexes between active and steady SLE patients.The correction of serum B factor and other laboratory and clinical indexes were also analyzed.Results Compared to healthy controls,patients with SLE had significantly lower value of serum B factor [（27.13 ± 8.98） mg/dl vs （36.73 ± 5.47） mg/dl,t =7.4,P 〈 0.01].Compared to steady SLE group,SLE active group had significantly lower level of serum factor B,C3 and C4,and also had significant higher level of C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR） （all P 〈 0.05）.Moreover,There were significant differences in the lower level of serum B factor between subgroups.Correlation analysis showed that the level of serum B factor was negatively associated with the levels of CRP and SLEDAI scores,whereas serum B factor was positively associated with the levels of C3 and C4 （all P 〈 0.05）.Conclusions Serum B factor is related to SLE.Serum B factor might be involved in the pathogenesis of SLE.Detection of serum B factor is helpful for diagnosis and evaluation of SLE disease activity.