补体C_3与C_4和IL-23在系统性红斑狼疮患者感染诊断中的价值

Value of complement C_3,complement C_4 and IL-23 in diagnosis of systemic lupus erythematosus patients with infection

目的探究补体C_3、C_4及白细胞介素-23(IL-23)在系统性红斑狼疮(SLE)患者感染中的表达及临床价值。方法选取2014年9月-2017年9月医院收治的SLE患者76例为研究对象。根据SLE疾病活动指数(SLE disease activity index,SLEDAI)评分将患者分为活动组46例、非活动组30例。另选取同期体检的健康者40名为对照组。比较SLE活动分组、感染患者、非感染患者、对照组的补体C_3、补体C_4、IL-23水平;并分析血清IL-23水平与补体C_3、C_4水平的相关性。结果活动组、非活动组、感染患者、非感染患者补体C_3、C_4均低于对照组(P<0.05),IL-23水平高于对照组(P<0.05)。活动组补体C_3、C_4分别为(0.32±0.04)mg/L、(0.11±0.03)mg/L低于非活动组,IL-23为(141.26±35.63)pg/ml高于非活动组(P<0.05)。感染患者补体C_3、C_4为(0.39±0.08)mg/L、(0.10±0.02)mg/L低于非感染患者,IL-23为(132.65±31.48)pg/ml高于非感染患者(P<0.05);相关分析示血清IL-23与补体C_3、C_4呈负相关(P<0.001)。结论 SLE疾病活动和感染时补体C_3、C_4水平呈低表达,IL-23水平呈高表达,补体C_3、C_4和IL-23水平变化对SLE病情活动和感染具有重要反映价值。

OBJECTIVE To investigate the expression and clinical value of complement C3,C4 and interleukin-23(IL-23)in infection of patients with systemic lupus erythematosus(SLE).METHODS Seventy-six patients with SLE admitted to our hospital from Sep.2014 to Sep.2017 were selected as the study subjects.The patients were divided into active group(46 cases)and inactive group(30 cases)according to SLE Disease Activity Index(SLEDAI).The patients were divided into infected group(n=28)and non-infected group(n=48)according to whether the infection was complicated or not.Another hospital selected the same period physical examination 40 cases of healthy people undergoing physical examination in the same period were selected as the control group.The levels of complement C3,complement C4 and IL-23 in patients with SLE,infected patients,non-infected patients,and the control group were observed and compared.The correlation between serum IL-23 level and levels of complement C3 and C4 was also analyzed.RESULTS The levels of complement C3 and C4 in active group,inactive group,infected group and non-infected group were significantly lower than those in control group(P<0.05),IL-23 level was significantly higher than that in the control group(P<0.05).Complement C3 and C4 levels in the active group were(0.32±0.04)mg/L and(0.11±0.03)mg/L,significantly lower than those in the inactive group,while the IL-23 level was(141.26±35.63)pg/ml,significantly higher than that in the inactive group(P<0.05).The levels of complement C3 and C4 in infected patients were(0.39±0.08)mg/L and(0.10±0.02)mg/L,lower than those in non-infected patients,and the level of IL-23 was(132.65±31.48)pg/ml,significantly higher than that in noninfected patients(P<0.05).Correlation analysis showed that serum IL-23 was negatively correlated with complement C3 and C4(P<0.001).CONCLUSION The expression levels of complement C3 and C4 are low and the level of IL-23 is high during SLE diseases and infections.The changes of complement C3,C4 and IL-23 levels have important value in the pathogenesis and infection of SLE.