重症肌无力病人血清中IL-38的表达及其与疾病严重程度和预后的关系  

Expression of IL-38 in the serum of MG patients and its relationship with disease severity and prognosis

作　　者：闫利莎 黄小雨 徐铭铭 王莹莹 肖成华 张勇 YAN Lisha;HUANG Xiaoyu;XU Mingming;WANG Yingying;XIAO Chenghua;ZHANG Yong(Graduate School of Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Department of Neurology,The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002,China)

机构地区：[1]徐州医科大学研究生院,江苏徐州221004 [2]徐州医科大学附属医院神经内科,江苏徐州221002

出　　处：《安徽医药》2025年第1期114-118,共5页Anhui Medical and Pharmaceutical Journal

基　　金：江苏省科研创新基金项目(SJCK22_1289)。

摘　　要：目的探讨白细胞介素-38(IL-38)在重症肌无力(MG)病人外周血中的表达及其与病情严重程度及预后的关系。方法选取2021年1月至2022年8月于徐州医科大学附属医院就诊的MG病人78例及同时期的健康对照者(HC)51例,该研究为基础研究,通过酶联免疫吸附测定(ELISA)检测其外周血清中IL-38的表达水平,通过Spearman相关分析IL-38与疾病严重程度重症肌无力定量评分(QMG)、重症肌无力综合量表(MGC)的相关性;采用二元logistic回归分析影响MG复发的独立危险因素,采用受试者操作特征曲线(ROC曲线)分析IL-38对MG复发的诊断价值。结果与对照组相比,研究组血清中IL-38的表达水平明显升高,差异有统计学意义(P<0.001);且全身型重症肌无力(GMG)病人血清中IL-38的表达水平(103.07±39.63)ng/L高于眼肌型重症肌无力(OMG)病人(87.39±46.88)ng/L,差异有统计学意义(P<0.05);IL-38与MG病人的QMG评分、MGC评分呈正相关(rs=0.60,P<0.001)、(rs=0.50,P<0.001);二元logistic回归分析结果表明IL-38、QMG评分是影响MG复发的独立危险因素(OR>1,P<0.05);ROC曲线结果显示IL-38(AUC=0.89)、QMG评分(AUC=0.86)对MG复发有良好的诊断价值。结论IL-38在MG病人中表达上调且与疾病严重程度相关,是影响MG复发的独立危险因素,动态监测IL-38对临床评估MG病人神经功能受损程度及预测MG复发具有一定价值。Objective To explore the expression of interleukin-38(IL-38)in the peripheral blood of patients with myasthenia gravis(MG)and its relationship with the severity and prognosis of the condition.Methods Seventy-eight patients with MG and 51 healthy controls(HC)during the same period in the Affiliated Hospital of Xuzhou Medical University from January 2021 to August 2022 were selected.This study was a fundamental research,the expression level of IL-38 in the patients´serum was detected using enzyme-linked immunosorbent assay(ELISA),and the correlation between IL-38 and disease severity Quantitative Mysthenia Gravis score(QMG)and Mysthenia Gravis Composite(MGC)score was analysed by Spearman correlation analysis.Binary logistic regression was used to analyze the independent risk factors those affected MG recurrence;and the receiver operating characteristic curve(ROC curve)was used to analyze the diagnostic value of IL-38 for MG recurrence.Results Compared with the control group,the expression level of IL-38 in the serum of the study group was significantly increased,with a statistically significant difference(P<0.001).Moreover,the expression level of IL-38 in the serum of patients with generalized myasthenia gravis(GMG)(103.07±39.63)ng/L was higher than that of patients with ophthalmic myasthenia gravis(OMG)(87.39±46.88)ng/L,and the difference was statistically significant(P<0.05);IL-38 was positively correlated with the QMG score(rs=0.60,P<0.001)and MGC score of MG patients(rs=0.50,P<0.001).The results of binary logistic regression analysis showed that IL-38 and QMG score were independent risk factors affecting MG recurrence(OR>1,P<0.05).The ROC curve results showed that IL-38(AUC=0.89)and QMG score(AUC=0.86)had good diagnostic value for MG recurrence.Conclusions IL-38 is upregulated in MG patients and is associated with disease severity,which is an independent risk factor for MG recurrence.Dynamic monitoring of IL-38 has certain value in clinical evaluation of neurological impairment in MG patients and prediction

关 键 词：重症肌无力 白细胞介素-38 重症肌无力定量评分 重症肌无力综合量表评分 危险因素 复发 

分 类 号：R746.1[医药卫生—神经病学与精神病学]