系统性红斑狼疮患者血清血小板反应蛋白1水平与病情严重程度的关系

The relationship between serum thrombospondin-1 level and severity of systemic lupus erythematosus

目的探讨系统性红斑狼疮(SLE)患者血清血小板反应蛋白1(TSP-1)水平与病情严重程度的关系。方法选取2010年1月~2018年12月中国人民解放军中部战区总医院(以下简称“我院”)收治的SLE患者110例为观察组,根据SLE疾病活动指数(SLEDAI-2000)评分将患者分为缓解期(49例,SLEDAI-2000评分<5分)和活动期(61例,SLEDAI-2000评分≥5分),另选取同期于我院进行健康体检的志愿者50名作为对照组。比较对照组、观察组及缓解期、活动期血清TSP-1水平与其他临床指标。分析血清TSP-1水平与SLE并发症的关系。采用Pearson相关性分析血清TSP-1水平与其他临床指标的相关性。结果观察组血清TSP-1水平高于对照组,血红蛋白、血小板、补体C3、补体C4低于对照组(P<0.05)。活动期患者的血清TSP-1水平高于缓解期,血红蛋白、血小板、补体C3、补体C4低于缓解期(P<0.05)。合并口腔溃疡、皮疹、脱发、关节炎、狼疮性肾炎、溶血性贫血的SLE患者血清TSP-1水平均高于未合并者(P<0.05)。Pearson相关性分析结果显示,TSP-1与血红蛋白、血小板、补体C3、补体C4呈负相关(r=-0.471、-0.462、-0.492、-0.537,P<0.05),而与肌酐、尿素氮、24 h尿蛋白无相关性(P>0.05)。结论SLE患者中存在血清TSP-1水平的异常升高,且其升高程度与患者病情严重程度密切相关,同时其异常释放可能对SLE并发症产生一定影响。

Objective To investigate the relationship between the level of serum thrombospondin-1(TSP-1)and the disease severity of patients with systemic lupus erythematosus(SLE).Methods One hundred and ten SLE patients admitted to Central War Zone General Hospital of Chinese People′s Liberation Army(“our hospital”for short)from January 2010 to December 2018 were selected as observation group.According to the SLE disease activity index(SLEDAI-2000)score,the patients were divided into remission period(49 cases,SLEDAI-2000 score<5 points)and active period(61 cases,SLEDAI-2000 score≥5 points).Another 50 volunteers who underwent physical examination in our hospital during the same period were selected as control group.The levels of serum TSP-1 in control group and observation group,remission period and active period were compared with other clinical indicators.The relationship between serum TSP-1 level and SLE complications was analyzed.Pearson correlation analysis was used to analyze the correlation between serum TSP-1 level and other clinical indicators.Results The level of serum TSP-1 in observation group was higher than that in control group,while the levels of hemoglobin,platelet,C3 and C4 in observation group were lower than those in control group(P<0.05).The level of TSP-1 in active phase was higher than that in remission phase,while levels of hemoglobin,platelet,C3 and C4 in active phase were lower than those in remission phase(P<0.05).The serum TSP-1 level of SLE patients with oral ulcer,rash,alopecia,arthritis,lupus nephritis and hemolytic anemia was higher than that of those without symptoms(P<0.05).Pearson correlation analysis showed that TSP-1 was negatively correlated with hemoglobin,platelet,C3 and C4(r=-0.471,-0.462,-0.492,-0.537,P<0.05),but not with creatinine,urea nitrogen and 24 h urinary protein (P > 0.05). Conclusion There is an abnormal increase in serum TSP-1 level of SLE patients, and the degree of increase is closely related to the disease severity of patients. At the same time, the abnormal release of TSP-1 may have some effect on the complications of SLE.