狼疮性肾炎患者血清微小RNA-146a和微小RNA-155水平及其预测病情活动的效能

Serum microRNA-146a and microRNA-155 levels and their predictive efficiency for disease activity in patients with lupus nephritis

目的探讨狼疮性肾炎(LN)患者血清微小RNA(miRNA)-146a、miRNA-155水平及其预测病情活动的效能。方法将122例LN患者根据系统性红斑狼疮疾病活动度指数(SLEDAI)分为LN活动组(65例)与LN稳定组(57例),另选取48例健康志愿者为对照组。比较3组间血清miRNA-146a、miRNA-155表达水平和常规实验室指标水平的差异,以及LN活动组和LN稳定组间疾病活动性指标的差异。分析LN患者血清miRNA-146a、miRNA-155表达水平与疾病活动性指标的相关性,采用受试者工作特征(ROC)曲线分析血清miRNA-146a、miRNA-155表达水平对LN病情活动的预测价值。结果对照组、LN稳定组、LN活动组血清肌酐、红细胞沉降率(ESR)水平依次升高,miRNA-146a和miRNA-155相对表达水平、C3和C4水平依次降低,其他两组估测肾小球滤过率水平均低于对照组(均P<0.05)。LN活动组患者抗双链DNA(ds-DNA)抗体、抗C1q抗体水平、SLEDAI、肾组织活动性指数和慢性指数、肾小管间质病变评分均高于LN稳定组(均P<0.05)。LN患者血清miRNA-146a、miRNA-155表达水平均与ESR、抗ds-DNA抗体、抗C1q抗体水平、SLEDAI呈负相关,而与C3水平呈正相关(P<0.05)。ROC曲线分析结果显示,miRNA-146a预测LN病情活动的敏感度为83.08%、特异度为91.23%,而miRNA-155的敏感度为84.62%、特异度为89.47%。结论LN患者血清miRNA-146a与miRNA-155表达水平降低,两者预测LN病情活动的效能均较高。

Objective To investigate serum microRNA(miRNA)-146a and miRNA-155 levels as well as their predictive efficiency for disease activity in patients with lupus nephritis(LN).Methods A total of 122 patients with LN were divided into LN-active group(65 cases)and LN-stable group(57 cases)according to the systemic lupus erythematosus disease activity index(SLEDAI),another 48 healthy volunteers were selected as control group.Expression levels of serum miRNA-146a and miRNA-155 as well as routine laboratory indexes levels were compared among the three groups,and disease activity index was compared between the LN-active group and the LN-stable group.The correlation of serum miRNA-146a and miRNA-155 expression levels with disease activity index was analyzed in LN patients,and the predictive value of serum miRNA-146a or miRNA-155 expression level for LN disease activity was analyzed by receiver operating characteristic(ROC)curve.Results Serum creatinine and erythrocyte sedimentation rate(ESR)levels increased in turn,and the relative expression levels of miRNA-146a and miRNA-155,as well as the levels of C3 and C4,decreased in turn in the control group,the LN-stable group and the LN-active group,the estimated glomerular filtration rate in the other two groups was lower than that in the control group(all P<0.05).Compared with the LN-stable group,the LN-active group yielded higher levels of anti double-strand DNA(ds-DNA)antibody and anti C1q antibody,and higher scores for SLEDAI,renal tissue activity index and chronic index,and tubular interstitial lesion(all P<0.05).In LN patients,serum miRNA-146a and miRNA-155 expression levels negatively correlated with ESR,anti ds-DNA antibody level,anti C1q antibody level and SLEDAI,but positively correlated with C3 level(P<0.05).ROC curve analysis results showed that the sensitivity and specificity of miRNA-146a for predicting LN disease activity were 83.08%and 91.23%respectively,and the sensitivity and specificity of miRNA-155 were 84.62%and 89.47%respectively.Conclusion Serum miRNA-146a and miRNA-155 expression levels are decreased in LN patients,both exhibit higher predictive efficiency for LN disease activity.