神经精神性狼疮患者血清IL-6、sTWEAK水平及临床意义

Serum IL-6 and sTWEAK levels in patients with neuropsychiatric systemic lupus erythematosus and their clinical significance

目的探讨神经精神性狼疮(NPSLE)患者血清白细胞介素(IL)-6、可溶性肿瘤坏死因子样凋亡微弱诱导剂(sTWEAK)水平及其临床意义。方法选择2017年2月至2021年9月河北省沧州市中心医院收治的165例系统性红斑狼疮患者,根据NPSLE发生与否分为NPSLE组(68例)和非NPSLE组(97例)。此外,根据系统性红斑狼疮疾病活动指数(SLEDAI)评分将NPSLE组患者分为轻度组(23例)、中度组(26例)、重度组(19例)。检测血清IL-6、sTWEAK水平,分析NPSLE发病的相关因素及IL-6、sTWEAK诊断NPSLE的价值。结果NPSLE组发病年龄低于非NPSLE组,病程长于非NPSLE组,SLEDAI评分高于非NPSLE组,差异有统计学意义(P<0.05)。NPSLE组血清IL-6、sTWEAK水平高于非NPSLE组,差异有统计学意义(P<0.05)。不同SLEDAI评分NPSLE患者血清IL-6、sTWEAK水平比较,差异有统计学意义(P<0.05)。其中,重度组高于中度组和轻度组,中度组高于轻度组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,SLEDAI评分(OR=1.872,95%CI:1.533~2.286,P<0.001)、IL-6(OR=1.370,95%CI:1.113~1.687,P=0.002)、sTWEAK(OR=1.508,95%CI:1.185~1.920,P<0.001)是NPSLE发生的危险因素。IL-6、sTWEAK诊断NPSLE的曲线下面积为0.698、0.692,联合IL-6、sTWEAK诊断NPSLE的曲线下面积为0.854,高于单独IL-6、sTWEAK诊断(P<0.05)。结论NPSLE患者血清IL-6、sTWEAK水平均增高,且与NPSLE发生和疾病活动性有关,可作为NPSLE诊断的辅助生物学指标。

Objective To investigate the levels of serum interleukin(IL)-6 and soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK)in patients with neuropsychiatric systemic lupus erythematosus(NPSLE)and their clinical significance.Methods A total of 165 patients with systemic lupus erythematosus admitted to Cangzhou Central Hospital in Hebei Province from February 2017 to September 2021 were selected and divided into NPSLE group(68 cases)and non-NPSLE group(97 cases)according to the occurrence of NPSLE.In addition,according to the systemic lupus erythematosus disease activity index(SLEDAI)score,the patients in the NPSLE group were divided into mild group(23 cases),moderate group(26 cases),and severe group(19 cases).Serum levels of IL-6 and sTWEAK were detected,and the related factors of NPSLE and the value of IL-6 and sTWEAK in the diagnosis of NPSLE were analyzed.Results The age of onset in the NPSLE group was lower than that in the non-NPSLE group,the disease duration was longer than that in the non-NPSLE group,and the SLEDAI score was higher than that in the non-NPSLE group,with statistically significant differences(P<0.05).The serum levels of IL-6 and sTWEAK in the NPSLE group were higher than those in the non-NPSLE group,and the differences were statistically significant(P<0.05).There were significant differences in serum IL-6 and sTWEAK levels in NPSLE patients with different SLEDAI scores(P<0.05).Among them,those of the severe group were higher than those of the moderate group and the mild group,while those of the moderate group were higher than those of the mild group,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that SLEDAI score(OR=1.872,95%CI:1.533-2.286,P<0.001),IL-6(OR=1.370,95%CI:1.113-1.687,P=0.002),sTWEAK(OR=1.508,95%CI:1.185-1.920,P<0.001)were risk factors for NPSLE.The areas under the curve of IL-6 and sTWEAK in the diagnosis of NPSLE were 0.698 and 0.692,and the area under the curve of combined IL-6 and sTWEAK in the diagnosis of NPSLE was 0.854,which was higher than that of IL-6 and sTWEAK alone(P<0.05).Conclusion Serum levels of IL-6 and sTWEAK are increased in NPSLE patients,and are related to the occurrence and disease activity of NPSLE,which can be used as auxiliary biological indicators for the diagnosis of NPSLE.