血清新蝶呤水平与系统性红斑狼疮的临床相关性研究  

Clinical correlation between serum neopterin level and systemic lupus erythematosus

作　　者：郭一学 田佳宜 李茹 李雪[1] 孙晓麟[1] GUO Yi-xue;TIAN Jia-yi;LI Ru;LI Xue;SUN Xiao-lin(Department of Rheumatology and Immunology,Beijing Key Laboratory for Rheumatism and Immune Diagnosis(BZ0135),Peking University People’s Hospitalt Beijing 1000441 China)

机构地区：[1]北京大学人民医院风湿免疫科风湿病机制及免疫诊断北京市重点实验室(BZ0135),北京100044

出　　处：《微生物学免疫学进展》2022年第2期23-28,共6页Progress In Microbiology and Immunology

基　　金：国家自然科学基金(81771743、81971520、81801619);北京大学人民医院研究与发展基金(科研)(RDX2019-03)。

摘　　要：目的 探讨系统性红斑狼疮(systemic lupus erythematosus, SLE)患者血清新蝶呤的水平及其与疾病的临床相关性。方法 纳入北京大学人民医院SLE患者72例,对照组为16名健康者,ELISA检测SLE组与对照组血清中新蝶呤的浓度,分析其与SLE患者临床表现及实验室指标的相关性。结果 SLE组血清中新蝶呤浓度[28.4 (5.8~180.4) nmol/L]高于健康对照组[6.7 (3.7~11.2) nmol/L],差异有统计学意义(P=0.008 1)。血清新蝶呤浓度与ESR、AnuA、aCL和IgG均呈正相关,与RBC、Hb、PLT和C3均呈负相关。受试者工作特征(receiver operating characteristic, ROC)曲线分析显示,新蝶呤区分SLE患者的敏感度为83.3%,特异性为93.7%。根据ROC曲线分析确定的阈值,将SLE患者分为血清新蝶呤水平正常组和血清新蝶呤水平升高组,血清新蝶呤水平升高组的RBC降低、Hb降低和ESR升高比例均高于血清新蝶呤水平正常组。此外,血清新蝶呤水平升高组出现蛋白尿以及anti-r-RNP阳性的比例也均高于血清新蝶呤水平正常组。结论 SLE患者血清中新蝶呤浓度与患者血液系统受累和肾脏受累相关,可能与自身抗体产生相关。因此,新蝶呤可能作为SLE血液系统及肾脏损伤的辅助判定指标。Objective To investigate the level of serum neopterin in patients with systemic lupus erythematosus(SLE) and its clinical correlation with the disease. Methods Seventy-two SLE patients in Peking University People’s Hospital were enrolled in the patient group, while sixteen healthy people as the control group. The concentration of neopterin in serum of SLE group and control group was detected by ELISA, and its correlation with clinical manifestations and laboratory indexes of SLE patients was analyzed. Results The concentration of neopterin in serum of SLE group [28.4(5.8-180.4) nmol/L] was significantly higher than that of control group [6.7(3.7-11.2) nmol/L](P=0.0081). Serum neopterin concentration was positively correlated with ESR, AnuA, aCL and IgG, and negatively correlated with RBC, Hb, PLT and C3. The receiver operating characteristic(ROC) curve analysis showed that the sensitivity and specificity of neopterin in differentiating SLE patients were 83.3% and 93.7%, respectively. According to the threshold determined by ROC curve analysis, SLE patients were divided into normal neopterin level group and elevated neopterin level group. The group with elevated neopterin level presented a higher proportion of decreased RBC and Hb, increased ESR, positive anti-r-RNP and proteinuria than the normal group. Conclusion The neopterin concentration in serum of SLE patients is related to the involvement of blood system and kidney, and may be related to autoantibody production. Therefore, neopterin may be used as a helpful index to determine the injury of blood system and kidney in SLE.

关 键 词：系统性红斑狼疮 新蝶呤 血液系统 生物标志物 

分 类 号：R593.24[医药卫生—内科学]