Semaphorin 3A在系统性红斑狼疮合并血小板减少患者中的水平及意义  

Association of Semaphorin 3A with thrombocytopenia in systemic lupus erythematosus

作　　者：郭倩[1,2] 马晓旭[1] 高辉[2] 石连杰[2] 钟昱超 谢琳峰[1] 邵苗[1] 张学武[1] GUO Qian;MA Xiao-xu;GAO Hui;SHI Lian-jie;ZHONG Yu-chao;XIE Lin-feng;SHAO Miao;ZHANG Xue-wu(Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing 100044, China;Department of Rheumatology and Immunology, Peking University International Hospital, Beijing 102206, China)

机构地区：[1]北京大学人民医院风湿免疫科,北京100044 [2]北京大学国际医院风湿免疫科,北京102206

出　　处：《北京大学学报（医学版）》2020年第5期892-896,共5页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(81501396)。

摘　　要：目的:通过测定血清Semaphorin 3A(Sema3A)的水平,分析Sema3A与系统性红斑狼疮(systemic lupus erythematosus,SLE)血小板减少的相关性。方法:应用酶联免疫吸附法检测170例SLE患者、50例干燥综合征(Sjogren’s syndrome,SS)患者、19例脾功能亢进(hypersplenism,HS)患者及150例健康对照(healthy controls,HC)血清中Sema3A的水平,收集患者及健康对照的临床资料及实验室检查,实验室检查主要为患者的血常规及骨髓穿刺活检结果。根据是否合并血小板减少及血小板减少是否缓解,将SLE患者分为SLE合并血小板减少组(41例)、SLE合并血小板减少缓解组(28例)及SLE未合并血小板减少组(101例)。根据是否合并血小板减少,将SS患者分为SS合并血小板减少组(18例)及SS未合并血小板减少组(32例)。将28例进行骨髓穿刺活检的SLE患者,根据骨髓象结果从骨髓增生情况方面将其分为骨髓增生正常组(19例)和增生减低组(9例),从巨核细胞成熟方面将其分为有巨核细胞成熟障碍组(8)和无巨核细胞成熟障碍组(20例)。比较各组Sema3A水平差异,并分析各组患者血清Sema3A水平与血小板的相关性及不同骨髓象间血清Sema3A的水平。结果:(1)SLE患者血清Sema3A水平较HC显著降低[(3.84±2.76)μg/L vs.(6.96±2.62)μg/L,P<0.001],SS患者血清Sema3A水平亦较HC显著降低[(4.35±3.57)μg/L vs.(6.96±2.62)μg/L,P<0.001],HS患者血清Sema3A水平较HC也明显降低[(5.67±2.26)μg/L vs.(6.96±2.62)μg/L,P=0.041]。(2)SLE患者血清Sema3A水平较SS患者降低,但差异无统计学意义[(3.84±2.76)μg/L vs.(4.35±3.57)μg/L,P=0.282],SLE患者血清Sema3A水平与HS患者相比显著降低,差异有统计学意义[(3.84±2.76)μg/L vs.(5.67±2.26)μg/L,P=0.006]。(3)SLE合并血小板减少组Sema3A水平显著低于SLE合并血小板减少缓解组[(1.28±1.06)μg/L vs.(3.83±2.65)μg/L,P<0.001]和SLE未合并血小板减少组[(1.28±1.06)μg/L vs.(4.87±2.60)μg/L,P<0.001],而SLE合并血小板减少Objective:To measure the level of serum Semaphorin 3A(Sema3A)and to analyze the relationship between serum Sema3A and systemic lupus erythematosus(SLE)with thrombocytopenia.Methods:The concentration of serum Sema3A was detected by enzyme-linked immuno sorbent assay(ELISA)in 170 SLE patients,50 Sjogren’s syndrome(SS)patients,19 hypersplenism(HS)patients and 150 healthy controls(HC).Based on the presence of thrombocytopenia and whether the thrombocytopenia was in remission,the SLE patients were divided into three groups:SLE with thrombocytopenia(41 cases),SLE with thrombocytopenia remission(28 cases),and SLE without thrombocytopenia(101 cases).According to whether there was thrombocytopenia,the SS patients were divided into SS with thrombocytopenia(18 cases)and SS without thrombocytopenia(32 cases).The 28 SLE patients who underwent bone marrow aspiration biopsy were divided into two groups from the aspect of whether the bone marrow hyperplasia was normal(19 cases)or low(9 cases),as well as from the aspect of whether the maturity disturbance of megakaryocyte was positive(8 cases)or negative(20 cases).The serum Sema3A levels in SLE,SS,HS with HC were compared,meanwhile,the correlation between serum Sema3A level and platelet(PLT)in the patients with different diseases analyzed.Results:(1)Serum Sema3A levels in SLE were significantly lower than in HC[(3.84±2.76)μg/L vs.(6.96±2.62)μg/L,P<0.001],serum Sema3A levels in SS were also obviously lower than in HC[(4.35±3.57)μg/L vs.(6.96±2.62)μg/L,P<0.001],and in HS it was lower than HC at a certain extant[(5.67±2.26)μg/L vs.(6.96±2.62)μg/L,P=0.041].(2)Serum Sema3A levels in SLE were slightly lower than in SS,but there was no significant difference[(3.84±2.76)μg/L vs.(4.35±3.57)μg/L,P=0.282].However,when compared with HS,serum Sema3A levels in SLE were significantly lower[(3.84±2.76)μg/L vs.(5.67±2.26)μg/L,P=0.006].(3)Serum Sema3A concentration in SLE with thrombocytopenia was significantly lower than in SLE with thrombocytopenia remission[(1.28±1.06)μg

关 键 词：Semaphorin 3A 红斑狼疮 系统性 血小板减少 

分 类 号：R593.24[医药卫生—内科学]