血清TL1A升高对ANCA相关血管炎活动度的临床价值  

Clinical value of elevated serum TL1A on the activity of ANCA associated vasculitis

作　　者：陈雪礼 薛国辉 华琳 刘晓峰 李观华 张启贵 晏慧民 CHEN Xueli;XUE Guohui;HUA Lin;LIU Xiaofeng;LI Guanhua;ZHANG Qigui;YAN Huimin(Department of Clinical Laboratory,Jiujiang NO.1 People's Hospital,Jiujiang,Jiangxi 332000,China;Department of Nephrology,Jiujiang NO.1 People's Hospital,Jiujiang,Jiangxi 332000,China)

机构地区：[1]九江市第一人医院检验科,江西九江332000 [2]九江市第一人医院肾内科,江西九江332000

出　　处：《国际检验医学杂志》2022年第17期2095-2099,2104,共6页International Journal of Laboratory Medicine

基　　金：江西省卫生健康委员会科技计划项目(SKJP220201245)。

摘　　要：目的探究血清肿瘤坏死因子配体相关分子1A(TL1A)在抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)患者中的表达变化及其临床价值。方法选取2019年9月至2022年2月在该院就诊并确诊为AAV的患者51例纳入AAV组,同期该院进行健康体检的体检健康者50例作为对照组。流式细胞术测定外周血辅助性T细胞17(Th17)细胞的频率,采用酶联免疫吸附试验测定血清TL1A、白细胞介素-17(IL-17)和IL-23的浓度。采用Spearman法用于评估血清TL1A与实验室指标、IL-17、IL-23、Th17及疾病活动度评分指标BVAS-2003间的相关性。结果AAV患者多为显微镜下多血管炎,肾脏和肺部表现最为常见。AAV组具有更高水平的白细胞计数(WBC)、中性粒细胞计数(NEU)、血尿素氮(BUN)、肌酐(Cr)、尿酸(UA)和C反应蛋白(CRP)以及更低水平的血红蛋白浓度(Hb)、淋巴细胞计数(LYM)、血清清蛋白(ALB)和肾小球滤过率(GFR),与对照组比较,差异均有统计学意义(P<0.05)。AAV组具有更高水平的TL1A(P<0.05),且Th17、IL-17及IL-23在AAV组中亦高于对照组,差异有统计学意义(P<0.05)。相关性结果显示AAV患者中血清TL1A与IL-17、Th17频率、CRP、2003版伯朝翰血管炎评分(BVAS-2003)及GFR间均呈显著相关性(均P<0.05)。受试者工作特征(ROC)曲线结果显示血清TL1A预测AAV疾病活动度具有较好的价值。结论血清TL1A与BVAS-2003评分密切相关,或可成为用于评价AAV疾病活动度的生物标志物。Objective To investigate the expression of serum TNF-like ligand 1A(TL1A)in patients with anti-neutrophil cytoplasmic antibody(ANCA)associated vasculitis(AAV)and its clinical value.Methods A total of 51 patients diagnosed as AAV in the hospital from September 2019 and February 2022 were selected the AAV group,and 50 healthy persons who undetment the physical examination during the same period were selected as study subjects.Flow cytometry was used to determine the frequency of peripheral blood Helper T cell 17(Th17),and enzyme-linked immunosorbent assay was used to determine the levels of serum TL1A,interleukin(IL)-17 and IL-23.Spearman method was used to assess the correlation between serum TL1A and laboratory indexes,IL-17,IL-23,Th17 and disease activity score index BVAS-2003.Results Patients with AAV tended to have microscopic polyangiitis,with renal and pulmonary manifestations being the most common.Patients with AAV had higher levels of white blood cells count(WBC),neutrophils count(NEU),blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA)and C-reactive protein(CRP),as well as lower levels of hemoglobin concentration(Hb),lymphocytes count(LYM),serum albumin(ALB)and glomerular filtration rate(GFR),all with statistically significant differences compared with the control group(P<0.05).Patients with AAV had higher levels of TL1A(P<0.05),and Th17,IL-17 and IL-23 were also higher in AAV group than those in the control group(P<0.05).The correlation results showed serum TL1A significantly correlated with IL-17,Th17 frequency,CRP,BVAS-2003 and GFR in patients with AAV(all P<0.05).The receiver operating characteristic(ROC)curve result showed that serum TL1A had a good value in predicting AAV disease activity.Conclusion Serum TL1A closely correlates with BVAS-2003 score and might be a biomarker used to evaluate AAV disease activity.

关 键 词：抗中性粒细胞胞浆抗体相关性血管炎 肿瘤坏死因子配体相关分子1A 疾病活动度 生物标志物 辅助性T细胞17 

分 类 号：R593.2[医药卫生—内科学]