系统性红斑狼疮中医证型与BAFF及疾病活动指标关系探讨

Exploration into Relationship Among TCM Syndrome Type,BAFF and Disease Activity Index in Patients with Systemic Lupus Erythematosus

目的:检测系统性红斑狼疮(Systemic Lupus Erythematosus,SLE)患者血清B细胞活化因子(B Cell Activating Factor,BAFF)表达水平,探讨SLE患者中医证型与BAFF水平及疾病活动指标关系。方法:采用酶联免疫吸附法(ELISA)检测91例SLE患者及20例健康对照血清BAFF水平,同时检测SLE患者红细胞沉降率、补体3(C3)、补体4(C4)、C反应蛋白(CRP)。结果:1)SLE患者血清中BAFF水平高于健康对照组(P<0.01),其中SLE疾病活动组BAFF水平高于健康对照组与SLE非活动组(P<0.01)。2)SLE患者BAFF水平与SLE疾病活动指数(SLE Disease Activity Index,SLEDAI)、红细胞沉降率呈正相关(r=0.73,r=0.39,P<0.01);与C3呈负相关(r=-0.34,P<0.01)。3)热毒炽盛型SLE患者血清中BAFF水平较其余中医证型组SLE均明显升高(P<0.01);正虚邪恋型组SLE患者BAFF水平较其他证型均明显降低(P<0.01)。结论:SLE患者BAFF水平明显升高,与疾病活动指标相关;热毒炽盛型SLE患者血清中BAFF水平较其他证型组均明显升高,正虚邪恋型组较其他证型组均明显降低,提示抗BAFF单抗在不同中医证型SLE中可能疗效不同。

Objective：To detect the serum levels of B cell activating factor （ BAFF） in patients with systemic lupus erythematosus （ SLE） and to investigate the relationship among TCM pattern , BAFF and disease activity index in patients with SLE .Methods：The serum levels of BAFF were measured by ELISA in 91 SLE patients and 20 health control group .Patients with SLE also tested the erythrocyte sedimentation rate （ESR）, complement 3 （C3）, complement 4 （C4）, C reactive protein （CRP）.Results：1） The levels of BAFF in SLE patients were significantly higher than those in the healthy control group （P〈0.01）, and the level of SLE disease activity group was significantly higher than that of the healthy control group and no activity group （P〈0.01）.2） The levels of BAFF SLE patients showed a positive correlation with SLE disease activity index （SLEDAI）（r=0.73, P〈0.01） and ESR （r=0.39, P〈0.01）, and showed a negative correlation with C3 （r=-0.34, P〈0.01）.3） The levels of BAFF in the heat-toxin flourishing type of SLE patients compared with other TCM patterns were significantly increased （P〈0.01）, and the as-thenic healthy qi with pathogen lingering pattern were significantly lower than other TCM patterns （ P〈0.01 ） .Conclusion： In SLE patients , the levels of BAFF were significantly increased and correlated with SLEDA .The correlation with TCM patterns indi-cates that anti BAFF monoclonal antibody in different TCM pattern of SLE patients may have different curative effects .