TLR9 mRNA表达水平与SLE患者病情及疾病进展的相关性

Correlation between TLR9 mRNA expression and SLE patients’ condition and disease progression

目的探讨Toll样受体9(TLR9)mRNA表达水平与系统性红斑狼疮(SLE)患者病情及疾病进展的相关性。方法纳入2016年6月至2018年3月在本院诊断及治疗的SLE患者129例,测定所有受试者TLR9 mRNA表达水平,以TLR9 m RNA表达水平中位数为界值,分为TLR9低表达组(n=62)和TLR9高表达组(n=62),记录所有患者临床参数。随访2年后,记录两组患者进展情况,应用Logistic回归分析影响SLE疾病进展的危险因素。结果 129例患者共5例因不同原因失访,共124例患者完成随访的患者中共60例患者发生疾病进展,将其作为进展组,余64例未发生疾病进展的患者作为非进展组;K-M生存分析曲线显示,TLR9高表达组SLE患者2年疾病进展风险高于TLR9低表达组(x2=5.971,P=0.015);Logistic多因素显示持续性蛋白尿(OR=0.083)、高C反应蛋白水平(OR=0.054)、TLR9 mRNA高表达(OR=0.090;)是SLE疾病进展危险因素,ROC曲线分析显示,TLR9 mRNA高表达预测SLE患者疾病进展风险的AUC为0.716,特异度为86.56%,敏感度为78.35%高于持续性蛋白尿、C反应蛋白水平(P<0.05)。结论持续性蛋白尿、C反应蛋白水平、TLR9 mRNA高表达是SLE患者疾病进展的危险因数,其中TLR9 mRNA高表达可作为预测SLE患者疾病进展风险的重要指标。

Objective To investigate the relationship between the expression level of Toll-like receptor 9(TLR9) m RNA and the condition and disease progression of patients with systemic lupus erythematosus(SLE)in this study. Methods A total of 129 SLE patients diagnosed and treated in our hospital from June 2016 to March 2018 were enrolled,and the TLR9 mRNA expression levels of all subjects were measured. The median TLR9 mRNA expression level was used as the cut-off value,and they were divided into TLR9 low expression groups(n=62)and TLR9 high expression group(n=62),and the clinical parameters of all patients were recorded. After 2 years of follow-up,the progress of the two groups of patients was recorded,and the risk factors that affected the progression of SLE were analyzed by logistic regression. Results A total of129 patients,5 cases were lost to follow-up due to different reasons,a total of 124 patients completed follow-up patients,a total of 60 patients had disease progression,which was regarded as the progressive group,and the remaining 64 patients without disease progression were regarded as the non-progressive group. Using the median of TLR9 mRNA expression as the cutoff value,they were divided into the TLR9 low expression group(n=62)and the TLR9 high expression group(n=62),KM survival analysis curve showed that the two-year risk of disease progression in SLE patients in the TLR9 high expression group was higher than that in the TLR9 low expression group(log-rank x2=0.000,P<0.015). Logistic multivariate showed persistent proteinuria(OR=0.083)and high C response Protein level(OR=0.054)and high TLR9 m RNA expression(OR=0.090;)are risk factors for SLE disease progression. ROC curve analysis shows that high TLR9 m RNA expression predicts the risk of disease progression in SLE patients with an AUC of 0.716 and a specificity of 86.56%. The sensitivity was 78.35% higher than that of persistent proteinuria and C-reactive protein(P<0.05). Conclusion Persistent proteinuria,C-reactive protein levels,and high TLR9 m RNA expression are risk factors for disease progression in SLE patients,and high expression of TLR9 m RNA can be used as an important indicator for predicting the risk of disease progression in SLE patients.