狼疮肾炎患者血清IL-31水平的表达与疾病活动性研究

The research on the expression of serum IL-31 and disease activity in patients with lupus nephritis

目的探讨狼疮肾炎(lupus nephritis,LN)患者血清白介素(interleukin,IL)-31水平的表达及其与肾脏疾病活动度的关系。方法选取九江市第一人民医院诊断LN患者54例作为观察组,前瞻性研究分析观察组基线及随访期临床数据。另外,选取体检中心28名健康人作为对照组,ELISA法检测各组血清IL-31水平的表达,并采用Spearman相关分析与疾病活动指标的相关性。结果观察组患者根据整体系统性红斑狼疮疾病活动指数(systemic lupus erythematosus disease activity index,SLEDAI)评分是否≥10分,分为活动组(≥10分,38例)及稳定组(<10分,16例),两组血清IL-31表达水平有明显差异[(83.7±16.2)ng/L比(72.5±14.1)ng/L,P=0.019];两组与健康对照组的(30.6±9.8)ng/L比较,差异均具有统计学意义。观察组患者未治疗前血清IL-31水平为(81.2±15.7)ng/L,明显高于免疫抑制剂治疗后的水平(71.4±16.3)ng/L(P=0.001)。Spearman相关分析观察组患者血清IL-31水平与SLEDAI评分(r=0.406,P=0.002)、24 h尿蛋白定量(r=0.529,P<0.001)、LN病理活动指数Austin评分(r=0.469,P=0.011)呈正相关;与细胞因子IL-6(r=0.670,P=0.026)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)(r=0.597,P=0.019)等水平呈一致性表达,与血清补体C3(r=-0.427,P=0.001)呈负相关。结论LN患者血清IL-31水平表达较高,且与疾病活动性呈正相关。

Objective To discuss the expression of serum IL-31 in patients with lupus nephritis(LN)and its correlation with kidney disease activity.Methods The clinical data of 54 patients with LN diagnosed in the First People’s Hospital of Jiujiang during the baseline and follow-up period(experimental group)were analyzed prospectively.Another 28 healthy people(control group)were selected from the physical examination center.The expression of serum IL-31 in each group was detected by ELISA.Its correlation with disease activity index was analyzed by Spearman correlation analysis.Result A total of 54 patients in LN experimental group were divided into active group(38 cases)and stable group(16 cases)according to whether the SLEDAI(SLE disease activity index)score was≥10.There was a significant difference in serum IL-31 expression between the two groups(83.7±16.2 vs.72.5±14.1)ng/L(P=0.019).There was significant difference between the two groups and the healthy control group(30.6±9.8)ng/L.The level of serum IL-31 in the LN group before treatment was significantly higher than that after immunosuppressive therapy(81.2±15.7 vs.71.4±16.3)ng/L(P=0.001).Spearman correlation analysis showed that the serum level of IL-31 in the experimental group was positively correlated with the overall SLEDAI score(r=0.406,P=0.002),24-h urine protein quantity(r=0.529,P<0.001),and LN pathological activity index Austin score(r=0.469,P=0.011).The expression was consistent with the levels of IL-6(r=0.670,P=0.026)and TNF-α(r=0.597,P=0.019),and was negatively correlated with serum complement C3(r=-0.427,P=0.001).Conclusion The level of IL-31 in LN patients is higher than that in healthy people,and it is positively related to disease activity.