抗SmD1抗体表达与狼疮肾炎预后的相关性分析

Correlation between anti-SmD1 antibody expression and prognosis of lupus nephritis

目的探讨与分析抗SmD1抗体表达与狼疮肾炎(Lupus nephritis,LN)预后的相关性。方法采用回顾性研究方法,2013年2月到2018年2月在湖北医药学院附属东风医院门诊与住院的系统性红斑狼疮(Systemic lupus erythematosus,SLE)患者60例作为SLE组,LN患者30例作为LN组,无结缔组织病患者32例作为对照组,检测三组血清抗SmD1抗体等抗体表达情况,记录患者的病情状况与随访预后。结果 LN组与SLE组的抗SmD1抗体、抗Sm抗体、抗dsDNA抗体、抗核抗体表达阳性率高于对照组,LN组高于SLE组,差异有统计学意义(P<0.05)。LN组、SLE组、对照组的SLEDAI评分分别为13.20±1.28分、8.29±2.47分和2.56±0.58分,差异均有统计学意义(F=9.424,P=0.001)。LN患者随访6个月期间死亡6例,死亡率为20.00%;直线相关性分析显示随访死亡与SLEDAI评分和抗SmD1抗体、抗Sm抗体表达阳性率都呈现显著正相关性(P<0.05);多因素Logistic回归分析显示SLEDAI评分和抗SmD1抗体、抗Sm抗体表达阳性率都为导致患者预后死亡的主要影响因素(P<0.05)。结论抗SmD1抗体在LN患者中呈现高表达装,在患者的病情判断及随访预后预测都有很好的应用价值,并且与患者预后存在显著相关性。

Objective To investigate the correlation between anti-SmD1 antibody expression and prognosis of lupus nephritis(LN).Methods In a retrospective study,60 patients with systemic lupus erythematosus(SLE)hospitalized in our hospital from February 2013 to February 2018 were included to the SLE group,30 patients with lupus nephritis(LN)were selected as the LN group,and 32 patients with no connective tissue disease were used as the control group.The serum anti-SmD1 antibody and other antibodies in the three groups were detected,and the patients’condition and followed-up prognosis were recorded.Results The positive rates of anti-SmD1 antibody,anti-Sm antibody,anti-dsDNA antibody and anti-nuclear antibody in the LN and SLE groups were higher than those in the control group,with antibodies in the LN group higher than those of the SLE group.The difference was statistically significant(P<0.05).The SLEDAI scores of the LN group,SLE group and control group were 13.20±1.28 points,8.29±2.47 points and 2.56±0.58 points,respectively.The difference was statistically significant(F=9.424,P=0.001).Six LN patients died during the 6-month followed-up period,and the mortality rate was 20.0%.The linear correlation analysis showed that there was a significant positive correlation between the follow-up death and the SLEDAI score,anti-SmD1 antibody as well as anti-Sm antibody expression(P<0.05).Multivariate logistic regression analysis showed that the SLEDAI score,positive rate of anti-SmD1 antibody and anti-Sm antibody were the main factors affecting the prognosis of patients(P<0.05).Conclusion Anti-SmD1 antibody has a high expression level in LN patients and is positively correlated with patient prognosis,which has a potential application in patients′follow-up prognosis.