系统性红斑狼疮患者血清sMICA,sMICB水平与自身抗体表达及疾病活动度的相关性研究  

Correlation among Serum sMICA,sMICB Levels,Autoantibody Expression and Disease Activity in Patients with Systemic Lupus Erythematosus

作　　者：冉涛 潘锋[1] 王永红[1] 庞会 文峰[1] 陈旭[1] 夏家财 RAN Tao;PAN Feng;WANG Yonghong;PANG Hui;WEN Feng;CHEN Xu;XIA Jiacai(Department of Clinical Laboratory,Qianjiang Hospital Affiliated to Chongqing University,Chongqing 409000,China)

机构地区：[1]重庆大学附属黔江医院检验科,重庆409000

出　　处：《现代检验医学杂志》2024年第4期100-104,149,共6页Journal of Modern Laboratory Medicine

基　　金：重庆市黔江区科技计划项目(黔科计2022058)。

摘　　要：目的探讨循环可溶性MHC-I类链相关蛋白A[soluble major histocompatibility complex class I-related chain A,sMICA)、可溶性MHC-I类链相关蛋白B(soluble major histocompatibility complex class I-related chain B,sMICB]与系统性红斑狼疮(systemic lupus erythematosus,SLE)疾病活动性、自身抗体的关系。方法选择2020年1月~2023年1月重庆大学附属黔江医院收治的156例SLE患者(SLE组)和门诊体检中心体检的103例健康志愿者(对照组)。根据SLE疾病活动度评分(SLE disease activity index,SLEDAI)将SLE患者分为轻度活动组(n=43)、中度活动组(n=69)和重度活动组(n=44)。检测血清sMICA,sMICB水平以及自身抗体、外周血NK细胞占比,Spearman或Pearson分析sMICA,sMICB与评分、自身抗体、外周血NK细胞占比的相关性,受试者工作特征(ROC)曲线用来分析sMICA和sMICB诊断SLE活动度的价值。结果SLE组血清sMICA(173.65±23.92 pg/ml),sMICB(96.35±15.74 pg/ml)水平高于对照组(32.51±6.27 pg/ml,12.03±2.47 pg/ml),外周血CD3^(-)CD56^(+)NK细胞(12.02%±2.65%)占比低于对照组(18.35%±3.71%),差异具有统计学意义(t=58.498,53.897,-16.010,均P<0.05)。重度活动组血清sMICA,sMICB水平高于中度活动组和轻度活动组(t=8.192,12.352;19.652,23.742,均P<0.05),外周血CD3^(-)CD56^(+)NK细胞占比低于中度活动组和轻度活动组(t=8.154,10.658,均P<0.05),差异具有统计学意义。不同疾病活动SLE患者抗‐dsDNA抗体、抗核抗体、抗核小体抗体和抗组蛋白抗体阳性率比较,差异具有统计学意义(χ^(2)=8.795,7.216,7.539,8.946,均P<0.05)。SLE患者血清sMICA,sMICB水平与SLEDAI评分、抗‐dsDNA抗体、抗核抗体、抗核小体抗体、抗组蛋白抗体呈正相关(r=0.206~0.402,均P<0.05),与外周血CD3^(-)CD56^(+)NK细胞占比呈负相关(r=-0.563,-0.427,均P<0.05)。sMICA和sMICB诊断SLE重度活动的曲线下面积为0.652,0.704,联合sMICA,sMICB诊断SLE重度活动的曲线下面积为0.812,高于单独诊断(Z=3.050,2.346,均P<0.05)�Objective To investigate the relationship among circulating soluble major histocompatibility complex class I-related chain A(sMICA),soluble major histocompatibility complex class I-related chain B(sMICB),the activity of systemic lupus erythematosus(SLE)and autoantibodies.Methods A total of 156 SLE patients(SLE group)and 103 healthy volunteers(control group)who underwent physical examination in outpatient physical examination center were selected from the Qianjiang Hospital Affiliated to Chongqing University from January 2020 to January 2023.According to SLE disease activity score(SLEDAI),these SLE patients were divided into mild activity group(n=43),moderate activity group(n=69),and severe activity group(n=44).Serum levels of sMICA and sMICB,and the proportion of autoantibodies and peripheral blood NK cells were detected.Spearman or Pearson method was used to analyze the correlation among sMICA,sMICB,score,autoantibodies and peripheral blood NK cells proportion.Receiver operating characteristics(ROC)curve was used to evaluate the value of sMICA and sMICB in the diagnosis of SLE activity.Results Serum sMICA(173.65±23.92 pg/ml)and sMICB(96.35±15.74 pg/ml)levels in SLE group were higher than those in control group(32.51±6.27 pg/ml,12.03±2.47 pg/ml),while the proportion of CD3^(-)CD56^(+)NK cells(12.02%±2.65%)in peripheral blood was lower than that in control group(18.35%±3.71%),and the differences were statistically significant(t=58.498,53.897,-16.010,all P<0.05).Serum sMICA and sMICB levels in severe active group were higher than those in moderately active group and mildly active group(t=8.192,12.352;19.652,23.742,all P<0.05),and the proportion of CD3^(-)CD56^(+)NK cells in peripheral blood was lower than that in moderate and mild active groups(t=8.154,10.658,P<0.05).The differences in positive rates of anti-dsDNA antibody,anti-nuclear antibody,antinucleosome antibody and anti-histone antibody in SLE patients with different disease activities were significant(χ^(2)=8.795,7.216,7.539,8.946,all P<0.05).Serum s

关 键 词：系统性红斑狼疮 自身抗体 可溶性MHC-I类链相关蛋白A 可溶性MHC-I类链相关蛋白B 自然杀伤细胞 

分 类 号：R593.241[医药卫生—内科学] R446.62[医药卫生—临床医学]