系统性红斑狼疮患者血清IgE水平及其与疾病活动性的关系

Total serum IgE levels and its relationship with disease activity in patients with systemic lupus erythematosus

目的评估系统性红斑狼疮(systemic lupus erythematosus,SLE)患者血清总IgE水平,并探讨其与SLE患者临床特征、实验室指标和疾病活动度的关系。方法检测SLE患者、健康对照和过敏性疾病患者血清总IgE水平。评估SLE患者临床症状和组织受累情况,采用SLE疾病活动度指数(SLE disease activity index 2000,SLEDAI 2K)评估疾病活动度。结果SLE患者血清总IgE(中位数44.2 U/ml,范围1.82~2630 U/ml)高于健康对照者(中位数35.65 U/ml,范围4.66~1130 U/ml,P=0.028),但低于过敏患者(中位数350.6 U/ml,范围72.16~2851 U/ml,P<0.001)。SLE患者中活动期患者总IgE(中位数208 U/ml,范围8.18~2510 U/ml)显著高于静止期患者(中位数26.05 U/ml,范围1.82~2630 U/ml,P<0.001);总IgE水平与SLE疾病活动度相关(r=0.51,P<0.001)。SLE患者IgE水平升高与是否合并过敏性疾病无关。结论SLE患者血清IgE水平升高,其升高与疾病活动度相关,与是否合并过敏性疾病无关。IgE可能在SLE发病中,尤其疾病活动阶段发挥免疫调节作用。

Objective The aim of this study was to assess the IgE serum levels in systemic lupus erythematosus(SLE)patients,and its associations with clinical features,laboratory results and disease activity.Methods The IgE serum concentrations in systemic lupus erythematosus patients,healthy subjects and allergic patients were determined by nephelometry.Clinical manifestations and tissue damage were evaluated in the SLE patients and the disease activity was assessed by SLE Disease Activity Index 2000.Results The IgE serum concentrations in SLE patients(median,44.2 U/ml;range,1.82-2630 U/ml)were higher than those in healthy volunteers(median,35.65 U/ml;range,4.66-1130 U/ml,P=0.028),while lower than those in allergic patients(median,350.6 U/ml;range,72.16-2851 U/ml,P<0.001).SLE patients with active disease(median,208 U/ml;range,8.18-2510 U/ml)had higher IgE levels as compared with patients with quiescent disease(median,26.05 U/ml;range,1.82-2630 U/ml,P<0.001).Positive correlation was found between total IgE levels and SLE disease activity(r=0.51,P<0.001).The IgE levels did not statistically differ with respect to the presence of allergic disease.Conclusion The increased IgE levels in SLE patients were associated with disease activity,and was not related with allergic disease.Our results demonstrate that IgE play an immunoregulatory role in lupus,especially in the stage of active disease.