狼疮性肾炎患者血清FGF-23、Gas6水平与疾病活动性的关系  

Relationship between serum FGF-23,Gas6 levels and disease activity in patients with lupus nephritis

作　　者：杨小杰 强建红 汤喜红[1] 高彩霞 冯彦飞[1] Yang Xiaojie;Qiang JianHong;Tang Xihong;Gao Caixia;Feng Yanfei(Department of Rheumatology and Immunology,Yan'an People's Hospital,Shaanxi Province,Yan'an 716000,China)

机构地区：[1]陕西省延安市人民医院风湿免疫科,716000

出　　处：《疑难病杂志》2024年第11期1358-1362,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：陕西省科协青年人才托举计划项目(20200305)。

摘　　要：目的探讨狼疮性肾炎(LN)患者血清成纤维细胞生长因子23(FGF-23)、生长停滞特异性蛋白6(Gas6)水平与疾病活动性的关系。方法选择2021年3月—2024年3月延安市人民医院风湿免疫科收治的LN患者119例为LN组,并根据系统性红斑狼疮疾病活动指数2000(SLEDAI-2000)评分分为活动亚组70例和非活动亚组49例,另选取同期医院健康体检者105例为健康对照组。采用酶联免疫吸附试验检测血清FGF-23、Gas6水平;Pearson相关分析血清FGF-23、Gas6水平与肾功能指标、SLEDAI-2000评分的相关性;多因素Logistic回归分析LN患者疾病活动性的影响因素;受试者工作特征(ROC)曲线评价血清FGF-23、Gas6水平对LN患者疾病活动性的诊断价值。结果LN组血清FGF-23、Gas6水平均高于健康对照组(t/P=21.040/<0.001、7.389/<0.001);活动亚组收缩压、舒张压、尿素氮(BUN)、血肌酐(SCr)、尿蛋白、SLEDAI-2000评分、FGF-23、Gas6均高于非活动亚组(t/P=2.356/0.020、3.717/<0.001、11.867/<0.001、17.152/<0.001、30.579/<0.001、19.439/<0.001、11.284/<0.001、10.818/<0.001),补体C3、C4水平低于非活动亚组(t/P=6.233/<0.001、12.329/<0.001);血清FGF-23、Gas6水平分别与BUN、SCr、尿蛋白、SLEDAI-2000评分呈正相关(FGF-23:r/P=0.410/<0.001、0.395/<0.001、0.326/0.002、0.563/<0.001;Gas6:r/P=0.352/<0.001、0.384/<0.001、0.311/0.008、0.509/<0.001),与补体C3、C4水平呈负相关(FGF-23:r/P=-0.408/<0.001、-0.377/<0.001;Gas6:r/P=-0.376/<0.001、-0.321/<0.001);多因素Logistic回归分析显示,高FGF-23、Gas6、尿蛋白水平是LN患者疾病活动的独立危险因素[OR(95%CI)=2.136(1.224~3.727)、1.865(1.171~2.967)、2.539(1.416~4.554)];血清FGF-23、Gas6水平及二者联合诊断LN患者疾病活动性的曲线下面积(AUC)分别为0.804、0.834、0.938,二者联合的AUC大于各自单独诊断(Z/P=3.843/<0.001、3.270/<0.001)。结论LN患者血清FGF-23、Gas6水平均增高,且与LN肾功能损伤、补体水平降低及疾病活动性�Objective To investigate the relationship between serum levels of fibroblast growth factor 23(FGF-23),growth arrest specific protein 6(Gas6)and disease activity in patients with lupus nephritis(LN).Methods One hundred and nineteen patients with LN admitted to the Department of Rheumatology and Immunology of Yan'an People's Hospital from March 2021 to March 2024 were selected as LN group,and were divided into active subgroup(70 cases)and inactive subgroup(49 cases)according to SLEDAI-2000 score.Another 105 healthy subjects were selected as the control group.Serum levels of FGF-23 and Gas6 were detected by enzyme-linked immunosorbent assay.The correlations between serum FGF-23 and Gas6 levels and renal function indexes and SLEDAI-2000 scores were analyzed by Pearson correlation analysis.The influencing factors of disease activity in LN patients were analyzed by multivariate Logistic regression.Receiver operating characteristic(ROC)curve to evaluate the diagnostic value of serum FGF-23 and Gas6 levels in disease activity in LN patients.Results The levels of FGF-23 and Gas6 in LN group were higher than those in healthy control group(t/P=21.040/<0.001 and 7.389/<0.001).Systolic blood pressure,diastolic blood pressure,urea nitrogen(BUN),blood creatinine(SCr),urinary protein,SLEDAI-2000 score,FGF-23 and Gas6 in active subgroup were higher than those in inactive subgroup.The levels of C3 and C4 were lower than those of inactive subgroups(t/P=2.356/0.020,3.717/<0.001,11.867/<0.001,17.152/<0.001,30.579/<0.001,19.439/<0.001,11.284/<0.001,10.818/<0.001,6.233/<0.001,12.329/<0.001);Serum FGF-23 and Gas6 levels were positively correlated with BUN,SCr,urinary protein and SLEDAI-2000 scores,respectively(r/P=0.410/<0.001,0.395/<0.001,0.326/0.002,0.563/<0.001;0.352/<0.001,0.384/<0.001,0.311/0.008,0.509/<0.001)were negatively correlated with the levels of C3 and C4(r/P=-0.408/<0.001,-0.377/<0.001;-0.376/<0.001,-0.321/<0.001);Multivariate Logistic regression analysis showed that High levels of FGF-23,Gas6 and urinary protein were ind

关 键 词：狼疮性肾炎 疾病活动性 成纤维细胞生长因子23 生长停滞特异性蛋白6 

分 类 号：R593.242[医药卫生—内科学]