β2-MG、HMGB1及OAS1与系统性红斑狼疮患者疾病严重程度及肾损害的相关性

Correlation of β2-MG,HMGB1 and OAS1 with disease severity and renal damage in patients with systemic lupus erythematosus

目的探讨系统性红斑狼疮(SLE)患者血清β2-微球蛋白(β2-MG)、高迁移率组蛋白B1(HMGB1)及2’,5’-寡腺苷酸合成酶1(OAS1)表达及与患者疾病严重程度和狼疮性肾损害的相关性。方法选取2014年8月-2019年8月汉中市中心医院收治的80例SLE患者,根据系统性红斑狼疮疾病活动度评分(SLEDAI评分)将患者分成轻度组(n=33)、中度组(n=26)和重度组(n=21)。比较各组SLE患者血清指标水平。根据SLE患者肾小球滤过率(eGFR)分为肾功能正常组、轻度异常组及中重度异常组,比较三组β2-MG、HMGB1及OAS1水平。行病理穿刺及HE染色观察SLE患者不同程度肾损害情况,分析β2-MG、HMGB1及OAS1与SLE患者疾病程度及肾损害的相关性。结果不同程度SLE患者血肌酐(Scr)、尿素氮(BUN)、清蛋白(ALB)、血小板(PLT)、血红蛋白(Hb)、C3、C4补体、抗dsDNA抗体定量、24 h尿蛋白(UTP)、eGFR、β2-MG、HMGB1及OAS1水平比较差异有统计学意义(P<0.05)。相关性分析结果显示,β2-MG、HMGB1及OAS1与Scr、BUN、UTP及抗dsDNA抗体定量存在明显正相关性(P<0.05),与ALB、PLT、Hb、C3、C4补体、eGFR存在明显负相关性(P<0.05)。通过SLE肾脏病理HE染色观察,不同程度SLE患者狼疮性肾炎的发生率比较差异有统计学意义(P<0.05)。肾功能正常组、肾功能轻度异常组及肾功能中重度异常组β2-MG、HMGB1及OAS1水平比较差异有统计学意义(P<0.05)。相关性分析结果显示,β2-MG、HMGB1及OAS1与SLE患者SLEDAI评分及肾损害程度存在明显相关性(P<0.05)。结论β2-MG、HMGB1及OAS1与SLE患者疾病严重程度和肾损害存在明显相关性,检测相关指标对于SLE发病及肾损害的临床诊治有重要参考价值。

Objective To investigate the expression of β-2 microglobulin(β2-MG),high mobility group box 1 protein(HMGB1) and 2’,5’-oligoadenylate synthetase 1(OAS1) in patients with systemic lupus erythematosus(SLE) and their relationship with disease severity and lupus renal damage in patients with systemic lupus erythematosus.Methods 80 patients with SLE admitted in our hospital from August 2014 to August 2019 were selected.According to the systemic lupus erythematosus disease activity scale(SLEDAI score),all patients were divided into mild group(n=33),moderate group(n=26) and severe group(n=21).The serum levels of SLE patients in each group were compared.According to the glomerular filtration rate(eGFR) of SLE patients,they were divided into normal renal function group,mild abnormal group,and moderate to severe abnormal group.The levels of β2-MG,HMGB1,and OAS1 in the three groups were compared.Pathological puncture and HE staining were performed to observe the degree of renal damage in patients with SLE.Spearman test was used to analyze the correlation of β2-MG,HMGB1 and OAS1 with the disease degree and renal damage of SLE patients.Results Serum creatinine(Scr),blood urea nitrogen(BUN),albumin(ALB),platelets(PLT),hemoglobin(Hb),C3,C4 complement,anti-dsDNA antibodies,24 h urine protein(UTP),β2-MG,HMGB1,OAS1 and eGFR were significantly different among patients with different degrees of SLE(P<0.05).Correlation analysis results show that β2-MG,HMGB1 and OAS1 were positively correlated with Scr,BUN,UTP and anti-dsDNA antibody(P<0.05),and were negatively correlated with ALB,PLT,Hb,C3,C4 complement,and eGFR(P<0.05).The difference in the incidence of lupus nephritis in patients with different degrees of SLE was statistically significant(P<0.05).The levels ofβ2-MG,HMGB1 and OAS1 in normal renal function group,mild renal function abnormal group and moderately severe renal function group were significantly different(P<0.05).Correlation analysis showed that β2-MG,HMGB1,and OAS1 were significantly correlated with SLEDAI scores and renal damage in SLE patients(P<0.05).Conclusions β2-MG,HMGB1,and OAS1 were significantly related to the degree of disease and renal damage in SLE patients.Detection of these indicators could provide a reference for the clinical diagnosis and treatment of SLE and renal damage.