白塞综合征生物标志物分布及其临床相关真实世界研究  

The distribution of biomarkers for Behcet syndrome and their clinical relevance in real-world studies

作　　者：李嘉辰 孙峰 刘田[1,2,3] Li Jiachen;Sun Feng;Liu Tian(Department of Rheumatology and Immunology,Peking University People's Hospital,Beijing 100044,China;Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis,Beijing 100044,China;Department of Rheumatology and Immunology,Shijiazhuang People's Hospital,Shijiazhuang 050030,China)

机构地区：[1]北京大学人民医院风湿免疫科,北京100044 [2]风湿病机制及免疫诊断北京市重点实验室,北京100044 [3]石家庄市人民医院风湿免疫科,石家庄050030

出　　处：《中华预防医学杂志》2024年第9期1341-1347,共7页Chinese Journal of Preventive Medicine

基　　金：北京大学医学部教育教学研究课题(2022YB09);白求恩·普爱医学研究基金项目(PAYJ-023)。

摘　　要：目的在真实世界研究中探究不同生物标志物在白塞综合征(BS)亚型中的分布及其与BS不同亚型的相关性。方法采用横断面研究,纳入2019—2022年在北京大学人民医院风湿免疫科诊断为BS的患者483例。记录患者初次诊断时的基本信息、临床特征,检测患者接受治疗前HLA-B51基因、多种自身抗体和抗链球菌溶血素O(ASO)阳性情况,血清免疫球蛋白、补体和白细胞介素6(IL-6)水平。采用logistic回归模型分析不同生物标志物与临床亚型的关系。结果研究对象中HLA-B51阳性129例(26.7%),抗内皮细胞抗体(AECA)阳性115例(23.8%),抗核抗体(ANA)阳性79例(16.4%),ASO阳性54例(11.2%),其余标志物阳性率不足5.0%。61例(12.6%)BS患者IgA、52例(10.8%)IgG、198例(41.0%)IL-6水平升高,31例(6.4%)IgM、54例(11.2%)C3、29例(6.0%)C4水平降低。IgA升高是BS关节型的危险因素(OR=2.652,P=0.011),补体C4降低是BS神经型的危险因素(OR=3.594,P=0.039),ASO阳性是BS胃肠型的危险因素(OR=2.578,P=0.041),IL-6升高是BS眼型的危险因素(OR=7.560,P=0.016)。结论HLA-B51和AECA是BS中最常见的生物标志物,IgA升高、补体C4降低、ASO阳性和IL-6升高是BS不同亚型的危险因素。Objective To explore the distribution of different biomarkers for Behcet′s syndrome(BS)and their correlation with distinct clinical phenotypes of BS patients in real-world studies.Methods This study was a retrospective cross-sectional study.A total of 483 patients diagnosed with BS in the Department of Rheumatology and Immunology,Peking University People′s Hospital from 2019 to 2022 were enrolled.The baseline information and clinical features of the patients were recorded at their first diagnosis and tested the level of HLA-B51,several auto-antibodies,antistreptolysin-O(ASO),immune globulin,complement in blood serum and interleukin-6(IL-6).Logistic regression was used to analyze the correlation of biomarkers and phenotypes.Results Among BS patients,the number of positive cases for HLA-B51,anti-endothelial cell antibody(AECA),antinuclear antibodies(ANA)and ASO was 129,115,79 and 54,respectively.The positive rate of other biomarkers was less than 5.0%.About 12.6%of patients with BS had an increased level of IgA(n=61),and 10.8%of patients had an increased level of IgG(n=52).About 41.0%of patients had increased levels of IL-6(n=198),and 6.4%of patients had decreased levels of IgM(n=31).About 11.2%of patients had decreased levels of C3(n=54),and 6.0%of patients had decreased levels of C4(n=29).Elevated IgA was a risk factor for the articular phenotype of BS(OR=2.652,P=0.011).Decreased complement C4 was a risk factor for the neurological phenotype of BS(OR=3.594,P=0.039).Positive ASO was a risk factor for the gastrointestinal phenotype of BS(OR=2.578,P=0.041).Elevated IL-6 was a risk factor for the ocular phenotype of BS(OR=7.560,P=0.016).Conclusion HLA-B51 and AECA are common biomarkers in BS.Elevated IgA,decreased complement C4,positive ASO,and elevated IL-6 are risk factors for different phenotypes of BS.

关 键 词：白塞综合征 生物标志物 临床亚型 横断面研究 

分 类 号：R597.9[医药卫生—内科学]