程序性细胞死亡蛋白1在系统性红斑狼疮、类风湿性关节炎和绝经后骨质疏松患者中的表达及其临床意义

Expression and clinical significance of programmed cell death protein 1 in patients with systemic lupus erythematosus,rheumatoid arthritis and postmenopausal osteoporosis

目的 探究程序性细胞死亡蛋白1 (PD-1)在系统性红斑狼疮(SLE)、类风湿性关节炎(RA)和绝经后骨质疏松症(PMOP)患者外周血单个核细胞(PBMCs)中的表达和诊断效用。方法 收集2020年7月—2021年7月本院门诊与住院SLE患者70例、RA患者74例以及PMOP患者78例,健康对照组65例,采用荧光定量PCR检测PD-1表达。结果 与健康对照组相比,SLE、RA和PMOP患者PBMCs PD-L1分子均表达上调,且SLE和RA活动组显著高于非活动组(均P<0.01);PMOP合并SLE及RA的患者PD-1显著上调(P<0.01);SLE、RA和PMOP患者PD-1水平与CRP成显著正相关(r值分别为0.362、0.343、0.344,P<0.05),SLE患者PD-1与抗dsDNA抗体滴度成正相关(P<0.01),RA患者PD-1与ESR成正相关关系(r=0.389,P<0.05);ROC曲线分析显示PD-1对SLE、RA和PMOP有一定的诊断价值(AUC值分别为0.66、0.76、0.67;灵敏度分别为62.86%、66.11%、66.67%;特异度分别为85.00%、86.33%、85.00%;(均P<0.01)。结论 PD-1在SLE、RA和PMOP PBMCs中显著上调,对SLE、RA和PMOP疾病具有一定的诊断价值。

Objective To investigate the expression and diagnostic efficacy of programmed cell death protein 1(PD-1) in peripheral blood mononuclear cells(PBMCs) of patients with systemic lupus erythematosus(SLE),rheumatoid arthritis(RA)and postmenopausal osteoporosis(PMOP).Methods From July 2020 to July 2021,70 SLE patients,74 RA patients,78PMOP patients,and 65 healthy controls(NC) were collected from outpatients and inpatients in our hospital from July 2020 to July 2021.The expression of PD-1 was detected by fluorescence quantitative PCR.Results Compared with the control group,the expressions of PBMCs PD-L1 molecules in SLE,RA and PMOP patients were all up-regulated,and the active SLE and RA group were significantly higher than the inactive group(P< 0.01);PMOP combined with SLE and PD-1 in RA patients was significantly up-regulated(P< 0.01);PD-1 level was significantly positively correlated with CRP in patients with SLE,RA and PMOP(r= 0.362,r= 0.343,r= 0.344,P< 0.05).PD-1 level was positively correlated with anti-dsDNA antibody titer in SLE patients(P< 0.01).PD-1 was positively correlated with ESR in RA patients(r= 0.389,P<0.05).ROC curve analysis shows that PD-1 has a certain diagnostic value for SLE,RA and PMOP(AUC were 0.66,0.76,0.67,respectively;Sensitivity were 62.86%,66.11%,66.67%,respectively;Specificity were 85.00%,86.33%,85.00%,respectively,P<0.01).Conclusion PD-1 is significantly up-regulated in SLE,RA and PMOP PBMCs,and has certain diagnostic value for SLE,RA and PMOP.