外周血中抗双链DNA抗体、抗核小体抗体在系统性红斑狼疮伴肾损害患者中的表达及对临床疗效的影响

Expression of Anti-Double Strand DNA Antibody and Anti-Nucleosome Antibody in Peripheral Blood of Patients with Systemic Lupus Erythematosus and Renal Damage and Its Influence on Clinical Efficacy

目的探讨外周血中抗双链DNA抗体(Anti-ds-DNA)、抗核小体抗体(ANuA)在系统性红斑狼疮(SLE)伴肾损害患者中的表达及对临床疗效的影响。方法回顾性分析,收集2018年1月至2020年12月驻马店市中医院收治的60例经阶段性治疗有效的SLE伴肾损害患者的临床资料,将其纳入治疗有效组;另外收集同期收治的60例经阶段性治疗无效的SLE伴肾损害患者的临床资料,将其纳入治疗无效组。收集患者一般资料,比较两组患者实验室相关指标[外周血Anti-ds-DNA、外周血ANuA、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))、自然杀伤(NK)细胞、血清免疫球蛋白G(IgG)]水平,分析外周血中Anti-ds-DNA、ANuA水平对SLE伴肾损害患者临床疗效的影响。结果两组患者性别、年龄、体质量指数、吸烟史、饮酒史、系统性红斑狼疮疾病活动度量表(SLEDAI)评分以及CD3^(+)、CD4^(+)、CD8^(+)、NK细胞水平比较,差异无统计学意义(P>0.05);与治疗有效组相比,治疗无效组外周血Anti-ds-DNA、ANuA水平升高,差异有统计学意义(P<0.05)。经logistic回归分析结果显示,外周血Anti-ds-DNA、ANuA过表达是SLE伴肾损害患者治疗无效的风险因子(OR>1,P<0.05)。绘制ROC曲线结果显示,外周血Anti-ds-DNA、ANuA单独及联合预测SLE伴肾损害患者治疗无效风险的AUC均>0.7,具有一定的预测价值,且联合检测的预测效能最好。结论外周血Anti-ds-DNA、ANuA高表达可能与SLE伴肾损害患者治疗无效有关,对预测SLE伴肾损害患者治疗无效风险有一定价值,入院时二者过表达可能增加SLE伴肾损害患者治疗无效的风险。

Objective To investigate the expression of anti-double strand DNA antibody(Anti-ds-DNA)and anti-nucleosome antibody(ANuA)in peripheral blood of patients with systemic lupus erythematosus(SLE)complicated with renal damage and its influence on the clinical efficacy.Methods A retrospective analysis was conducted,the clinical data of 60 patients with SLE and renal damage(whose stage treatment was effective)who were treated in Zhumadian Hospital of Traditional Chinese Medicine from January 2018 to December 2020 were collected,and conducted them as the effective group.The clinical data of 60 patients with SLE and renal damage(whose stage treatment was ineffective)who were treated during the same period were collected,and conducted them as the ineffective group.Baseline data of patients were collected,the laboratory indexes[Anti-ds-DNA in peripheral blood,ANuA in peripheral blood,T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+)),natural killer(NK)cells,serum immunoglobulin G(IgG)]of the two groups were compared,the influence of Anti-ds-DNA and ANuA levels in peripheral blood on clinical efficacy of SLE patients with renal damage was analyzed.Results There was no statistical significant difference in gender,age,body mass index,smoking history,drinking history,systemic lupus erythematosus disease activity inventory(SLEDAI)score,CD3^(+),CD4^(+),CD8^(+)and NK cell levels of the two groups(P>0.05).Compared with the effective group,the levels of Anti-ds-DNA and ANuA in peripheral blood of the ineffective group were increased,the difference was statistically significant(P<0.05).The logistic regression analysis showed that the overexpression of Anti-ds-DNA and ANuA in peripheral blood were risk factors for ineffective treatment of SLE patients with renal damage(OR>1,P<0.05).The ROC curve showed that the AUC of Anti-ds-DNA and ANuA in peripheral blood alone or combined to predict the risk of ineffective treatment of SLE patients with renal damage were>0.7,which had certain predictive value and the prediction efficiency of combined detection was the best.Conclusion The high expression of Anti-ds-DNA and ANuA in peripheral blood may be related to ineffective treatment of SLE patients with renal damage,which had certain value in predicting the risk of ineffective treatment of SLE patients with renal damage,overexpression of Anti-ds-DNA and ANuA at admission may increase the risk of ineffective treatment in SLE patients with renal damage.