血清β2微球蛋白水平与系统性红斑狼疮疾病活动度及狼疮性肾损害程度的相关性研究  

Correlation of Serum β2-microglobulin Level with Disease Activity of Systemic Lupus Erythematosus and Degree of Lupus Nephritis

作　　者：张宗玮 陈铖[1] 王惠明[1] 丁国华[1] ZHANG Zongwei;CHEN Cheng;WANG Huiming;DING Guohua(Department of Nephrology,Remin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院肾内科

出　　处：《中国全科医学》2019年第17期2058-2063,共6页Chinese General Practice

基　　金：国家自然科学基金资助项目(81570617,81770687);十二五科技支撑计划资助项目(2011BA110B04)

摘　　要：背景系统性红斑狼疮(SLE)可引起狼疮性肾炎(LN),从而极大地影响SLE患者的生存率。β2微球蛋白(β2-MG)是存在于人有核细胞膜上的一种小分子蛋白质,其与SLE疾病活动度及狼疮性肾损害程度的相关性目前还未明确。目的探讨血清β2-MG水平与SLE疾病活动度及狼疮性肾损害程度的关系,为临床评价SLE疾病活动度及狼疮性肾损害程度提供参考指标。方法选取2016年1月-2018年1月武汉大学人民医院皮肤科及肾内科就诊的SLE患者260例,采集患者一般资料、实验室检查指标及系统性红斑狼疮疾病活动度评分表(SLEDAI)评分。根据SLEDAI评分将患者分为轻度活动组(SLEDAI评分0~9分)118例、中度活动组(SLEDAI评分10~14分)76例、重度活动组(SLEDAI评分≥15分)66例;根据估算肾小球滤过率(eGFR)将患者分为肾功能正常组177例、肾功能轻度异常组45例、肾功能中度异常组23例、肾功能重度异常组9例及肾功能极重度异常组6例。采用多因素Logistic回归分析SLE患者疾病活动度及肾功能的影响因素。结果不同疾病活动度组患者年龄、LN检出率、β2-MG、血红蛋白(Hb)、血小板计数(PLT)、清蛋白(ALB)、血肌酐(Scr)、eGFR、抗Sm抗体、抗dsDNA抗体阳性率、C3、C4、24 h尿蛋白定量(UTP)比较,差异均有统计学意义(P<0.05);不同肾功能组患者年龄、病程、LN检出率、β2-MG、Hb、PLT、ALB、Scr、C3、SLEDAI评分比较,差异均有统计学意义(P<0.05)。相关性分析显示β2-MG与年龄、LN、Scr、抗dsDNA抗体、UTP、SLEDAI评分呈正相关,与Hb、PLT、ALB、eGFR、C3呈负相关(P<0.05);eGFR与LN、Hb、PLT、ALB、抗RNP抗体、C3呈正相关,与年龄、β2-MG、Scr、BUN、抗dsDNA抗体、SLEDAI评分呈负相关(P<0.05);SLEDAI评分与LN、β2-MG、Scr、抗Sm抗体、抗dsDNA抗体、抗RNP抗体、UTP呈正相关,与年龄、Hb、PLT、ALB、eGFR、C3、C4呈负相关(P<0.05)。多因素Logistic回归分析结果显示,β2-MG[OR=1.1Background Systemic lupus erythematosus(SLE)can lead to lupus nephritis(LN),which greatly affects the survival rate of patients with SLE.β2-microglobulin(β2-MG)is a small-molecule protein which exists on human nucleated cell membranes.The correlation betweenβ2-MG and the disease activity of SLE and lupus kidney damage is still unclear.Objective To investigate the relationship between serumβ2-MG and disease activity of SLE and degree of lupusnephritis,so as to provide reference for clinical evaluation of SLE disease activity and lupus kidney damage.Methods A total of 260 SLE patients admitted to Dermatological Department and Nephrology Department of Renmin Hospital of Wuhan University from January 2016 to January 2018 were enrolled.General data,laboratory tests and scores of Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)were collected.According to SLEDAI score,118 cases were in mild activity group(SLEDAIscore 0-9),76 cases in moderate activity group(SLEDAI score 10-14),and 66 cases in severe activity group(SLEDAIscore≥15).According to estimated glomerular filtration rate(eGFR),patients were divided into normal renal function group(177 cases),mild abnormal renal function group(45 cases),moderate abnormal renal function group(23 cases),severe abnormal renal function group(9 cases)and extremely severe abnormal renal function group(6 cases).Multivariate Logistic regression was used to analyze the influencing factors of renal function and disease activity in patients with SLE.Results There were significant differences in age,percentage of LN,β2-MG,platelet count(PLT),hemoglobin(Hb),albumin(ALB),serum creatinine(Scr),eGFR,anti-Sm antibody,positive rate of anti-dsDNA antibody,C3 and C4 and 24-hour urinary total protein(UTP)in different disease activity groups(P<0.05);there were significant differences in age,course of disease,LN percentage,β2-MG,Hb,PLT,ALB,Scr,C3,and SLEDAI scores among different renal function groups(P<0.05).Correlation analysis showed thatβ2-MG was positively correlated with age,L

关 键 词：红斑狼疮 系统性 狼疮肾炎 Β2微球蛋白 肾功能 疾病活动度 

分 类 号：R593.241[医药卫生—内科学]