TWEAK、CD163在初诊系统性红斑狼疮合并肾脏损伤患者单核细胞中的表达及意义  

Expression and Significance of TWEAK and CD 163 in Monocytes of Patients with Newly Diagnosed Systemic Lupus Erythematosus Complicated with Renal Involvement

作　　者：张露 曾璐璐 罗清[1] Zhang Lu;Zeng Lulu;Luo Qing(Center of Clinical Laboratory,The First Affiliated Hospital of Nanchang University,Nanchang 330309,China)

机构地区：[1]南昌大学第一附属医院检验中心,南昌330309

出　　处：《成都医学院学报》2024年第6期1018-1023,1027,共7页Journal of Chengdu Medical College

基　　金：江西省自然科学基金面上项目(No:20171BAB205113);江西省教育厅科学技术研究项目(No:GJJ200107)。

摘　　要：目的检测系统性红斑狼疮(SLE)合并肾脏损伤(SLE+RI)患者单核细胞中的TWEAK、CD163表达水平,探讨其在SLE及SLE+RI诊断中的应用价值。方法应用实时荧光定量聚合酶链反应(RT-qPCR)法对58例SLE患者及各对照组患者单核细胞中TWEAK、CD163的表达水平进行测定。分析SLE+RI患者单核细胞中TWEAK、CD163的表达水平与实验室检查、临床表现的关系。应用受试者工作特征(ROC)曲线分析TWEAK、CD163对SLE+RI诊断及鉴别诊断的敏感度及特异度。结果SLE组单核细胞中TWEAK、CD163的表达水平高于HC和RA组,SLE+RI组高于SLE-RI组,抗双链DNA抗体(anti-dsDNA)阳性患者表达水平高于anti-dsDNA阴性患者,尿蛋白阳性患者高于尿蛋白阴性者;SLE+RI组治疗后二者表达水平低于治疗前(P<0.05)。SLE和SLE+RI组单核细胞中TWEAK、CD163表达水平与SLE活动度评分(SLEDAI)呈正相关。ROC曲线分析显示,TWEAK表达在区分SLE+RI疾病组与SLE-RI组的曲线下面积(AUC)为0.829;CD163在区分SLE+RI组与SLE-RI组的AUC为0.783,联合单核细胞中TWEAK、CD163的表达在区分SLE+RI组与SLE-RI组的AUC为0.792。结论SLE组TWEAK、CD163表达水平升高,且SLE组表达水平高于SLE-RI组,同时与疾病活动性、自身抗体以及临床症状密切相关,可作为SLE+RI的诊断及活动性标志物。Objective To detect the expression levels of tumour necrosis factor-like weak inducer of apoptosis(TWEAK)and CD 163 in the monocytes of patients with systemic lupus erythematosus complicated with renal involvement(SLE+RI),and to explore the application value of TWEAK and CD 163 in the diagnosis of SLE and SLE+RI.Methods The expression levels of TWEAK and CD 163 in the mononuclear cells of 58 SLE patients and control groups were determined by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).The relationship between TWEAK and CD 163 expression levels in the monocytes of SLE+RI patients and laboratory examination results and clinical manifestations was analyzed.The sensitivity and specificity of TWEAK and CD 163 in the diagnosis and differential diagnosis of SLE+RI were analyzed by receiver operating characteristic(ROC)curve.Results The expression levels of TWEAK and CD 163 in monocytes were higher in the SLE group than those in the healthy controls(HC)and rheumatoid arthritis(RA)control group,those in the SLE+RI patients were higher than those in the SLE patients without RI(SLE-RI),those in the patients with positive anti-double-stranded DNA antibody(anti-dsDNA)were higher than those in the patients with negative anti-dsDNA,those in the patients with positive urine protein were higher than those in the patients with negative urine protein,and those after treatment were lower than those before treatment in SLE+RI patients(P<0.05).The expression levels of TWEAK and CD 163 in monocytes were positively correlated with SLE Disease Activity Index(SLEDAI)in the SLE and SLE+RI groups.ROC curve analysis showed that the area under the curve(AUC)of TWEAK expression in the differential diagnosis of SLE+RI and SLE-RI was 0.829,the AUC of CD 163 expression in the differential diagnosis of SLE+RI and SLE-RI was 0.783,and the AUC of the combination of TWEAK and CD 163 in the differential diagnosis of SLE+RI and SLE-RI was 0.792.Conclusion The expression levels of TWEAK and CD 163 are increased in SLE patients

关 键 词：系统性红斑狼疮 肾损害 肿瘤坏死因子凋亡微弱诱导剂 CD163 标志物 

分 类 号：R593.241[医药卫生—内科学]