纤维蛋白原/白蛋白比值与系统性红斑狼疮肾脏损害及疾病活动度的相关性  

The correlation analysis between the fibrinogen⁃albumin ratio and renal damage and disease activity of systemic lupus erythematosus

作　　者：张想想 潘海峰[2] 王德光[1] ZHANG Xiangxiang;PAN Haifeng;WANG Deguang(Department of Nephrology,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China;Department of Epidemiology and Health Statistics,School of Public Health,Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学第二附属医院肾脏内科,合肥230601 [2]安徽医科大学公共卫生学院流行病与卫生统计学系,合肥230032

出　　处：《中华疾病控制杂志》2023年第8期933-939,共7页Chinese Journal of Disease Control & Prevention

基　　金：安徽省自然科学基金(2008085MH244);安徽医科大学第二附属医院国家自然科学基金孵育计划项目(2020GMFY04);安徽医科大学2020年临床与前期学科共建项目(2020lcxk022)。

摘　　要：目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)初诊患者纤维蛋白原/白蛋白比值(fibrinogen⁃albumin ratio,FAR)与肾脏损害及疾病活动度的相关性。方法以159例健康人群作为对照组,回顾性分析156例SLE初诊患者的相关临床数据。结果SLE患者的FAR明显高于对照组(Z=-10.390,P<0.001),SLE患者中重度活动组FAR明显高于轻度活动组(Z=-4.703,P<0.001),狼疮肾炎组FAR明显高于非狼疮肾炎组(Z=-6.312,P<0.001);SLE患者的FAR和补体C3(r=-0.249,P=0.002)、血清总蛋白(r=-0.474,P<0.001)呈负相关,和血沉(r=0.383,P<0.001)、C-反应蛋白(r=0.293,P<0.001)、血尿素氮(r=0.220,P=0.006)、血尿酸(r=0.296,P<0.001)、血肌酐(r=0.180,P=0.025)、24 h尿蛋白(r=0.588,P<0.001)及SLE疾病活动度指数(r=0.430,P<0.001)呈正相关;多因素logistic回归分析模型分析显示FAR是SLE疾病中重度活动(OR=1.010,95%CI:1.003~1.018,P=0.008)、肾脏损害(OR=1.020,95%CI:1.009~1.032,P<0.001)的独立危险因素。根据受试者工作特征曲线,FAR用于诊断SLE、SLE疾病中重度活动及肾脏损害的曲线下面积分别为0.84(95%CI:0.79~0.88)、0.72(95%CI:0.64~0.80)及0.80(95%CI:0.72~0.87)。结论FAR与SLE患者疾病活动度、肾脏损害相关,对评估SLE疾病活动度及肾脏损害具有一定的临床意义。Objective To explore the relationship between the fibrinogen⁃albumin ratio(FAR)and renal damage and disease activity in newly diagnosed patients with systemic lupus erythematosus(SLE).Methods The medical records of relevant clinical data of 156 newly diagnosed SLE patients and 159 healthy controls were retrospectively analyzed.Results The FAR of SLE patients was significantly higher than that of healthy controls(Z=-10.390,P<0.001).The FAR of SLE patients in the moderate and severe disease activity group was higher than that in the mild disease activity group(Z=-4.703,P<0.001).The FAR in lupus nephritis group was significantly higher than that in non⁃lupus nephritis group(Z=-6.312,P<0.001).The FAR of SLE patients was negatively correlated with complement 3(r=-0.249,P=0.002),serum total protein(r=-0.474,P<0.001),and positively correlated with erythrocyte sedimentation rete(r=0.383,P<0.001),C⁃reactive protein(r=0.293,P<0.001),blood urea nitrogen(r=0.220,P=0.006),uric acid(r=0.296,P<0.001),creatinine(r=0.180,P=0.025),24⁃hour urine protein(r=0.588,P<0.001)and SLE disease activity index(r=0.430,P<0.001).Multivariate logistic regression analysis showed that FAR was an independent risk factor for moderate to severe SLE activity and renal damage.According to receiver operating characteristic curve,the areas under the curve of FAR for diagnosis of SLE,prediction of moderate to severe SLE activity and renal damage were 0.84(95%CI:0.79-0.88),0.72(95%CI:0.64-0.80),0.80(95%CI:0.72-0.87),respectively.Conclusions FAR is associated with disease activity and renal damage in SLE patients,and has certain clinical significance for assessing SLE disease activity and renal damage.

关 键 词：纤维蛋白原/白蛋白比值 系统性红斑狼疮 狼疮肾炎 疾病活动度 

分 类 号：R593.241[医药卫生—内科学]