初诊SLE患者抗CTLA-4抗体水平及其临床意义  

Study on the relationship between anti-CTLA-4 antibody and disease activity of new-onset systemic lupus erythematosus

作　　者：尹玉峰 周二叶[1] 武剑[1] YIN Yufeng;ZHOU Erye;WU Jian(Department of Rheumatology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院风湿免疫科,江苏苏州215006

出　　处：《安徽医学》2024年第7期816-820,共5页Anhui Medical Journal

基　　金：苏州市科技发展计划(编号:SLJ2021009)。

摘　　要：目的探讨初诊系统性红斑狼疮(SLE)患者血清中抗CTLA-4抗体水平及其临床意义。方法选取2022年1月至2023年6月在苏州大学附属第一医院风湿免疫科就诊的初诊SLE患者56例作为病例组,同时选取我院体检中心52例体检者作为对照组。采用酶联免疫吸附试验(ELISA)检测两组血清中IgG和IgM型抗CTLA-4抗体。比较不同临床特征(包括皮疹、口腔溃疡、浆膜炎等等)初诊SLE患者组间抗CTLA-4抗体水平差异。采用Pearson相关分析评估初诊SLE患者抗CTLA-4抗体与疾病活动指标[包括SLE疾病活动指数2000版(SLEDAI-2K)、抗ds-DNA以及C反应蛋白(CRP)]的关系。结果病例组IgG和IgM型抗CTLA-4水平均高于对照组(t=4.657、5.014,P均<0.05);IgG和IgM型抗CTLA-4抗体水平在SLE合并浆膜炎的患者中高于未合并浆膜炎患者(t=1.849、2.013;P=0.046、0.032);Pearson相关分析显示,IgM型抗CTLA-4抗体与SLEDAI-2K(r=0.425,P=0.029)及补体C3(r=-0.494,P=0.029)呈正相关;IgG和IgM型抗CTLA-4抗体与CRP(r=0.301、0.404;P=0.041、0.022)和抗ds-DNA抗体(r=0.644、0.363;P=0.002、0.036)呈正相关。结论初诊SLE患者血清抗CTLA-4抗体呈高表达,且该抗体与浆膜炎、疾病活动度相关。Objective To investigate the levels of anti-CTLA-4 antibodies in the serum of patients with newly-onset systemic lupus erythematosus(SLE)and their clinical significance.Methods A total of 56 patients with newly-onset SLE admitted to the Department of Rheumatology and Immunology,the First Affiliated Hospital of Soochow University from January 2022 to June 2023 were selected as the case group,and 52 individuals from the Physical Examination Center of the hospital were selected as the control group.Enzyme-linked immunosor⁃bent assay(ELISA)was used to detect the levels of IgG and IgM anti-CTLA-4 antibodies in the serum of the two groups.The levels of anti-CTLA-4 antibodies were compared among newly-onset SLE patients with different clinical features(including rash,oral ulcers,serositis,etc.).Pearson correlation analysis was used to evaluate the relationship between anti-CTLA-4 antibodies and disease activity indicators[including Systemic Lupus Erythematosus Disease Activity Index 2000(SLEDAI-2K),anti-ds-DNA,and C-reactive protein(CRP)]in newly-onset SLE patients.Results The levels of IgG and IgM anti-CTLA-4 antibodies in the case group were higher than those in the control group(t=4.657,5.014,P<0.05 for both).The levels of IgG and IgM anti-CTLA-4 antibodies in SLE patients with serositis were higher than those without sero⁃sitis(t=1.849,2.013;P=0.046,0.032).Pearson correlation analysis showed that IgM anti-CTLA-4 antibody was positively correlated with SLEDAI-2K(r=0.425,P=0.029)and complement C3(r=-0.494,P=0.029);IgG and IgM anti-CTLA-4 antibodies were positively correlated with CRP(r=0.301,0.404;P=0.041,0.022)and anti-ds-DNA antibody(r=0.644,0.363;P=0.002,0.036).Conclusions The serum anti-CTLA-4 antibody is highly expressed in newly-onset SLE patients,and this antibody is associated with serositis and disease activity.

关 键 词：初诊 系统性红斑狼疮 细胞毒性T淋巴细胞相关蛋白4 浆膜炎 疾病活动度 

分 类 号：R593.241[医药卫生—内科学]