SLE患者免疫球蛋白及补体表达水平与疾病活动性的关系探讨

Relationship between expression of immunoglobulin and complement and disease activity in patients with systemic lupus erythematosus

目的探讨系统性红斑狼疮(SLE)患者免疫球蛋白及补体表达水平及临床意义。方法选择2018年2月—2020年4月本院接诊的64例SLE患者为试验组,按照SLE疾病活动指数(Systemic lupus erythematosus disease activity index,SLEDAL)将试验组分为非活动组和活动组,选择同时期在本院行健康体检的64例健康者为对照组。测定所有受检者血清免疫球蛋白IgG、IgM、IgA及补体C3、C4水平。比较每组免疫球蛋白及补体表达水平差异,分析免疫球蛋白及补体表达与SLE患者疾病活动性相关性。结果活动组IgA、IgG、IgM水平为(3.23±0.74)g/L、(22.04±5.45)g/L、(2.51±0.67)g/L,高于非活动组的(2.80±0.80)g/L、(18.54±3.47)g/L、(1.30±0.44)g/L,高于对照组的(2.14±0.67)g/L、(11.59±4.18)g/L、(1.01±0.39)g/L,(P值均<0.05);活动性组C3、C4水平为(0.54±0.11)g/L、(0.10±0.03)g/L,低于非活动组的(0.89±0.14)g/L、(0.17±0.06)g/L,低于对照组的(1.12±0.32)g/L、(0.26±0.09)g/L,(P值均<0.05);IgG、IgM、IgA与SLE患者SLE疾病活动指数(SLEDAL)评分呈正相关(P值均<0.05),补体C3、C4与SLE患者SLEDAL评分呈负相关(P值均<0.05)。结论 SLE患者免疫球蛋白水平明显升高,补体水平降低,免疫球蛋白及补体表达水平与疾病活动性密切相关,可以为临床治疗提供参考。

Objective To investigate the expression and clinical significance of immunoglobulin and complement in patients with systemic lupus erythematosus(SLE).Methods A total of 64 patients with SLE admitted in a hospital from February 2018 to April 2020 were selected as the experimental group.According to systemic lupus erythematosus disease activity index(SLEDAI),the experimental group was further divided into an inactive subgroup and an active subgroup.Totally64 healthy people who underwent physical examinations in the hospital during the same period were selected as the control group.Among all the objects,the serum immunoglobulin IgG,IgM,IgA and complement C3,C4 levels were measured.The expression levels of immunoglobulin and complement in each group were compared,and the correlation between the expression of immunoglobulin and complement and disease activity of SLE patients was analyzed.Results The levels of IgA,IgG and IgM in the active subgroup were(3.23±0.74) g/L,(22.04±5.45) g/L,and(2.51±0.67) g/L respectively,which were higher than those in the inactive subgroup [(2.80±0.80) g/L,(18.54±3.47) g/L,and(1.30±0.44) g/L respectively],and which were also higher than those in the control group [(2.14±0.67) g/L,(11.59±4.18) g/L,and(1.01±0.39) g/L respectively](all P<0.05).The levels of C3 and C4 in the active subgroup were(0.54±0.11) g/L and(0.10±0.03) g/L respectively,which were lower than those in the inactive subgroup [(0.89±0.14) g/L and(0.17±0.06) g/L respectively],and also lower than those in the control group [(1.12±0.32) g/L and(0.26±0.09) g/L respectively],(both P <0.05).IgG,IgM,and IgA were positively correlated with SLEDAI scores(all P <0.05),but complement C3,C4 were negatively correlated with SLEDAI scores(both P <0.05).Conclusion The levels of immunoglobulin in SLE patients are significantly increased,but the levels of complement are significantly decreased.The levels of immunoglobulin and complement are closely related to disease activity,which can provide the reference for clinical treatment.