血浆GAS5联合免疫学指标在系统性红斑狼疮患者诊断中的应用价值

Diagnostic Value of Plasma GAS5 Combined with Immunological Indexes in Patients with Systemic Lupus Erythematosus

目的探讨血浆生长特异性阻滞因子5(GAS5)联合免疫学指标[血清免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、补体C3、C4]在系统性红斑狼疮患者诊断中的应用价值。方法选取本院2020年1月至2023年1月收治的100例系统性红斑狼疮患者作为观察组,将患者分为缓解期组42例和活动期组58例。另选取同期健康体检志愿者100例作为对照组。比较对照组与观察组、缓解期组与活动期组血浆GAS5、血清IgA、IgM、C3、C4水平;Pearson相关系数分析血浆GAS5、血清IgA、IgM、C3、C4水平与患者病情严重程度的相关性;ROC曲线分析血浆GAS5、血清IgA、IgM、C3、C4水平单独及五者联合检测诊断系统性红斑狼疮的价值。结果观察组血浆GAS5、血清C3、C4低于对照组,血清IgA、IgM高于对照组,差异有统计学意义(P<0.05);缓解期组血浆GAS5、血清C3、C4高于活动期组,血清IgA、IgM低于活动期组,差异有统计学意义(P<0.05);血浆GAS5、血清C3、C4与患者病情严重程度呈负相关,血清IgA、IgM与患者病情严重程度呈正相关,差异有统计学意义(r=-0.432、-0.412、-0.358、0.621、0.583,P<0.05);血浆GAS5、血清IgA、IgM、C3、C4联合检测诊断系统性红斑狼疮的AUC值高于单项检测,差异有统计学意义(Z_(GAS5~联合检测)=4.152、Z_(IgA~联合检测)=7.128、Z_(IgM~联合检测)=7.477、Z_(C3~联合检测)=6.019、Z_(C4~联合检测)=5.685,P<0.05)。结论血浆GAS5联合免疫学指标是鉴别诊断系统性红斑狼疮的有效方式,可判断疾病病情进展。

Objective To investigate the application value of plasma growth specific blocking factor 5(GAS5)combined with immunological indexes[serum immunoglobulin A(IgA),immunoglobulin M(IgM),complement C3,C4]in the diagnosis of systemic lupus erythematosus(SLE).Methods A total of 100 patients with SLE admitted to our hospital from January 2020 to January 2023 were selected as the observation group,and the patients were divided into remission group(42 cases)and active group(58 cases).Another 100 healthy volunteers were selected as control group.Plasma GAS5,serum IgA,IgM,C3 and C4 levels were compared between control group and observation group,remission group and active group.Pearson correlation coefficient was used to analyze the correlation between plasma GAS5,serum IgA,IgM,C3 and C4 levels and the severity of patients'disease.ROC curve was used to analyze the value of plasma GAS5,serum IgA,IgM,C3,C4 levels alone and combined detection of the five levels in the diagnosis of systemic lupus erythematosus.Results Plasma GAS5,serum C3 and C4 in observation group were lower than those in control group,serum IgA and IgM were higher than those in control group,the difference was statistically significant(P<0.05).Plasma GAS5,serum C3 and C4 in remission group were higher than those in active group,and serum IgA and IgM were lower than those in active group,the difference was statistically significant(P<0.05).Plasma GAS5,serum C3 and C4 were negatively correlated with the severity of the disease,while serum IgA and IgM were positively correlated with the severity of the disease,with statistical significance(r=-0.432,-0.412,-0.358,0.621,0.583,P<0.05).The AUC value of combined detection of plasma GAS5,serum IgA,IgM,C3 and C4 in the diagnosis of systemic lupus erythematosus was higher than that of single detection.The difference was statistically significant(Z_(GAS5~combined detection)=4.152,Z_(IgA~combined detection)=7.128,Z_(IgM~combined detection)=7.477,Z_(C3~combined detection)=6.019,Z_(C4~combined detection)=5.685,P<0.05).Conclusion Plasma GAS5 combined with immunological markers is an effective Methods for the differential diagnosis of systemic lupus erythematosus,which can determine the progression of the disease.