apoB/apoA1对系统性红斑狼疮活动性和预后不良预测价值的研究  

Study on predictive value of apoB/apoA1 for activity and poor prognosis of systemic lupus erythematosus

作　　者：李子胜 赵伟 冯志刚 李岩 曹科峰 LI Zisheng;ZHAO Wei;FENG Zhigang;LI Yan;CAO Kefeng(Department of Laboratory,Taihe Hospital of Anhui University of Traditional Chinese Medicine,Fuyang,236600,China)

机构地区：[1]安徽中医药大学附属太和中医院检验科,安徽阜阳236600

出　　处：《临床血液学杂志》2023年第10期716-722,共7页Journal of Clinical Hematology

基　　金：安徽中医药大学基金项目(No:2021LCTH01)。

摘　　要：目的:分析载脂蛋白B(apoB)/载脂蛋白A1(apoA1)对系统性红斑狼疮(systemic lupus erythematosus, SLE)活动性以及预后不良预测价值的研究。方法:回顾性分析住院治疗的SLE患者131例,根据SLE病情活动程度评分(SLEDAI)分为活动期SLE 81例,其中轻度活动期25例,中度活动期20例,重度活动期36例;稳定期SLE 50例。根据活动期SLE治疗12个月后回访结果,将活动性SLE分为预后不良组(41例)、临床缓解组(40例),分析apoB/apoA1对疾病活动性和预后不良预测价值。结果:apoB、apoA1、apoB/apoA1对活动性SLE的曲线下面积(AUC)分别为0.621、0.662、0.733,对重度活动性SLE的AUC分别为0.609、0.621、0.692,apoB/apoA1对活动性SLE、重度活动性SLE预测价值均高于apoB、apoA1,差异均有统计学意义(Z=3.172、3.981,均P<0.05)。无论是否校正混杂因素,apoB/apoA1均为SLEDAI≥5分、SLEDAI≥10分、SLEDAI≥15分的影响因素。apoB/apoA1、apoB与SLEDAI呈正相关,apoA1与SLEDAI呈负相关,r值分别为0.474、0.192、-0.273(均P<0.05)。二元logsitic回归显示,apoB/apoA1、血沉、抗-双链DNA(dsDNA)均为活动性SLE的独立影响因素,白蛋白、补休C3均为保护性因素,OR值分别为5.120、2.142、2.632、0.702、0.621。apoB、apoA1、apoB/apoA1对活动性SLE预后不良AUC分别为0.625、0.650、0.732,apoB/apoA1对活动性SLE预后不良预测价值高于apoB、apoA1,差异有统计学意义(Z=3.525、4.217,均P<0.05)。二元logsitic回归显示,apoB/apoA1、抗dsDNA均为SLE预后不良独立影响因素,补休C3、ALB则为保护性因素,OR值分别为4.980、2.727、0.610、0.807(均P<0.05)。结论:apoB/apoA1对活动性SLE、重度活动性SLE、预后不良SLE有较高预测价值,且为活动性SLE、预后不良SLE独立影响因素。Objective To analyze the predictive value of apolipoprotein B(apoB)/apolipoprotein A1(apoA1) in the activity and poor prognosis of systemic lupus erythematosus(SLE).Methods A total of 131 SLE patients diagnosed in our hospital were collected and divided into active SLE and stable SLE, severe active SLE and non severe active SLE according to the disease activity. According to the results of 12 months follow-up after the active SLE treatment, active SLE was divided into poor prognosis group and clinical remission group. The predictive value of apoB/apoA1 on disease activity and poor prognosis was analyzed.Results The area under the curve(AUC) of apoB, apoA1, apoB/apoA1 for active SLE was 0.621, 0.662, 0.733, and for severe active SLE was 0.609, 0.621, 0.692, respectively. The predictive value of apoB/apoA1 for active SLE and severe active SLE was higher than that of apoB and apoA1, and the difference was statistically significant(all P < 0.05). Whether or not the confounding factors were corrected, the apoB/apoA1 was still the influencing factor of SLEDAI≥5, SLEDAI≥10 and SLEDAI≥15. The apoB/apoA1 and apoB were positively correlated with SLEDAI, while the apoA1 was negatively correlated with SLEDAI, the r values were 0.474, 0.192 and -0.273 respectively(all P < 0.05). The binary logsitic analysis showed that the apoB/apoA1, ESR and anti dsDNA were independent influencing factors of active SLE, while the ALB and C3 were protective factors, the OR values were 5.120, 2.142, 2.632, 0.702 and 0.621, respectively. The AUC of apoB, apoA1 and apoB/apoA1 for poor prognosis of active SLE were 0.625, 0.650 and 0.732 respectively. The predictive value of apoB/apoA1 for poor prognosis of active SLE was higher than that of apoB and apoA1, and the difference was statistically significant(all P < 0.05). The binary logsitic analysis showed that the apoB/apoA1 and anti dsDNA were independent factors for poor prognosis of SLE, while the C3 and ALB were protective factors, the OR values were 4.980, 2.727, 0.610 and 0.807 respect

关 键 词：系统性红斑狼疮 载脂蛋白B 载脂蛋白A1 预后不良 血脂分析 

分 类 号：R593.24[医药卫生—内科学]