血清IgG、TBX21、miR-335联合检测诊断狼疮性肾炎的临床价值

Clinical value of combined detection of serum IgG,TBX21 and miR-335 in diagnosis of lupus nephritis

目的探讨血清免疫球蛋白G(IgG)、T-框蛋白21(TBX21)、微小RNA-335(miR-335)联合检测诊断狼疮性肾炎(LN)的临床价值。方法选取柘城中医院2021年1月至2023年1月收治的95例LN患者为观察组,取同期95例健康体检人员为对照组,另根据入院时系统性红斑狼疮疾病活动度(SLEDAI)将LN患者分为活动期(51例,SLEDAI评分>4分)和稳定期(44例,SLEDAI评分0~4分)2个亚组。比较2组血清IgG、TBX21、miR-335水平,比较不同活动度血清IgG、TBX21、miR-335、尿素氮(BUN)、血肌酐(Scr)、补体C3、补体C4水平及SLEDAI评分,分析血清IgG、TBX21、miR-335水平与BUN、Scr、补体C3、补体C4水平及SLEDAI评分相关性,并分析血清IgG、TBX21、miR-335对LN的诊断价值。结果与对照组相比,入院时观察组血清IgG、TBX21、miR-335水平均较高(均P<0.05);入院时活动期患者血清IgG、TBX21、miR-335水平均高于稳定期患者(均P<0.05);入院时活动期患者BUN、Scr、SLEDAI评分均高于稳定期患者,补体C3、补体C4水平均低于稳定期患者(均P<0.05);入院时血清IgG、TBX21、miR-335水平与BUN、Scr、SLEDAI评分均呈正相关,与补体C3、补体C4水平均呈负相关(均P<0.05);血清IgG、TBX21、miR-335水平联合诊断LN的曲线下面积(AUC)大于单一检测(P<0.05)。结论血清IgG、TBX21、miR-335与疾病活动度密切相关,临床上可将其作为诊断和预测LN的参考指标,以便早期制定有针对性的治疗方案。

Objective To investigate the clinical value of combined detection of serum immunoglobulin G(IgG),T-frame protein 21(TBX21),and microRNA-335(miR-335)in the diagnosis of lupus nephritis(LN).Methods Ninety-five patients with LN treated in our hospital from January 2021 to January 2023 were selected as the observation group,while ninety-five healthy individuals were selected as the control group.Based on the systemic lupus erythematosus disease activity index(SLEDAI)score at admission,the LN patients were divided into two subgroups:the active LN group(51 cases,SLEDAI score>4)and the stable LN group(44 cases,SLEDAI score=0-4).The levels of serum IgG,TBX21,and miR-335 were compared between the two groups,and the levels of serum IgG,TBX21,miR-335,blood urea nitrogen(BUN),serum creatinine(Scr),complement C3,complement C4,and SLEDAI score were compared between the two groups.The correlations of serum IgG,PTX3,and miR-335 levels with BUN,Scr,complement C3,complement C4,and SLEDAI scores were analyzed.The diagnostic value of serum IgG,TBX21,and miR-335 in LN was evaluated.Results Compared with the control group,the levels of serum IgG,TBX21,and miR-335 in the observation group were higher on admission(all P<0.05).The serum levels of IgG,TBX21,and miR-335 in patients with the active stage were higher than those in patients with the stable stage on admission(all P<0.05).On admission,the BUN,Scr,and SLEDAI scores of patients in the active stage were higher than those in the stable stage,and the levels of complement C3 and C4 were lower than those in the stable stage(all P<0.05).The levels of serum IgG,TBX21,and miR-335 on admission were positively correlated with BUN,Scr,and SLEDAI scores and negatively correlated with complement C3 and C4 levels(all P<0.05).The area under the curve(AUC)of the combination of serum IgG,TBX21,and miR-335 levels in the diagnosis of LN was greater than that of single detection(P<0.05).Conclusions Serum IgG,TBX21,and miR-335 are closely related to disease activity and can be used as reference indicators for the diagnosis and prediction of LN in clinical practice,enabling the development of early targeted treatment plans.