狼疮性肾炎患者血清HMGB1、IL-23、IL-17水平及与疾病活动度的关系  

Serum HMGB1,IL-23,and IL-17 levels and their relationships with disease activity in patients with lupus nephritis

作　　者：刘佳 陈南芳 郭琳红 刘畅 燕丽君 王贺 王治国 LIU Jia;CHEN Nanfang;GUO Linhong;LIU Chang;YAN Lijun;WANG He;WANG Zhiguo(Department of Rheumatology and Immunology,Tangshan Central Hospital,Tangshan 063000,Hebei,China)

机构地区：[1]唐山中心医院风湿免疫科,河北唐山063000

出　　处：《贵州医科大学学报》2025年第1期141-146,152,共7页Journal of Guizhou Medical University

基　　金：河北省医学科学研究重点课题计划项目(20231838)。

摘　　要：目的 探讨狼疮性肾炎(lupus nephritis,LN)患者血清高迁移率族蛋白B1(high mobility group box-1 protein,HMGB1)、白细胞介素-23(interleukin 23,IL-23)、白细胞介素-17(interleukin 17,IL-17)水平与疾病活动度的关系。方法 选取LN患者127例作为研究组,另选取同期肾穿刺活检证实微小病变的患者66例作为对照组,比较2组临床资料、实验室指标[24 h尿蛋白(24 h urinary protein,24h Upro)、血肌酐(serum creatinine,Scr)、尿素氮(blood urea nitrogen,BUN)、白细胞计数(white blood cell,WBC)、中性粒细胞计数(neutrophil count,NEUT)、中性粒细胞与淋巴细胞比值(neutrophil and lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet-to-lymphoccyte ratio,PLR)]及血清HMGB1、IL-23、IL-17水平;根据患者疾病活动度情况再分为活动组(n=83)和稳定组(n=44),比较活动组和稳定组的临床资料和血清HMGB1、IL-23、IL-17水平;采用多因素logistic回归分析LN患者疾病活动度的影响因素,绘制受试者工作特征(ROC)曲线下面积(AUC)分析血清HMGB1、IL-23、IL-17水平对LN患者疾病活动度的诊断价值。结果 研究组LN患者血清HMGB1、IL-23、IL-17、24 h Upro、Scr、BUN、WBC、NEUT、NLR、PLR水平均高于对照组(P<0.05);活动组LN患者SLEDAI评分、HMGB1、IL-23、IL-17、Scr、BUN均高于稳定组(P<0.05);Person相关性分析显示,LN患者血清HMGB1、IL-23、IL-17水平与SLEDAI评分呈正相关(r=0.456;r=0.372;r=0.334,P<0.05);logistic回归分析表明,HMGB1(OR=1.182,P=0.000)、IL-23(OR=1.027,P=0.000)、IL-17(OR=2.164,P=0.027)为LN患者疾病活动度的影响因素(P<0.05);ROC曲线显示,血清HMGB1、IL-23、IL-17水平联合分析对LN患者疾病活动度诊断的AUC为0.911,高于单一HMGB1的0.822、IL-23的0.798、IL-17的0.696,且差异具有统计学意义(Z=3.109;Z=3.388;Z=4.674,P<0.05)。结论 LN患者血清HMGB1、IL-23、IL-17水平与疾病活动度相关,三者联合分析可用于LN患者疾病活动度的诊断。Objective To explore serum high mobility group protein B1(HMGB1),interleukin 23(IL-23),and IL-17 levels and their relationships with disease activity in patients with lupus nephritis(LN).Methods A total of 127 patients with LN were selected as study group,and 66 patients with minor lesions confirmed by renal needle biopsy during the same period were selected as control group.Two groups were compared on clinical data,laboratory indicators [24 h urinary protein(24h Upro),serum creatinine(Scr),blood urea nitrogen(BUN),white blood cell count(WBC),neutrophil count(NEUT),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and the levels of serum HMGB1,IL-23,and IL-17.According to disease activity,the patients were divided into active group(n=83) and stable group(n=44).Active and stable groups were compared on clinical data and levels of serum HMGB1,IL-23,and IL-17.Multivariate Logistic regression was used analyze the influencing factors of disease activity in LN patients.Receiver operating characteristic curve(ROC) was plotted to analyze the diagnostic values of serum HMGB1,IL-23,and IL-17 levels for disease activity in LN patients.Results Serum levels of HMGB1,IL-23,IL-17,24 h Upro,Scr,BUN,WBC,NEUT,NLR,and PLR were higher in study group than those in control group(P<0.05).SLEDAI score,HMGB1,IL-23,IL-17,Scr,and BUN were higher in active group than those in stable group(P<0.05).Pearson correlation analysis showed that serum HMGB1,IL-23,and IL-17 levels were positively correlated with SLEDAI score(r=0.456,r=0.372,r=0.334;P<0.05).Logistic regression analysis showed that HMGB1(OR=1.182,P<0.001),IL-23(OR=1.027,P<0.001),and IL-17(OR=2.164,P=0.027) were influencing factors of disease activity in the patients with LN(P<0.05).ROC curves analysis showed that AUC of HMGB1 combined with IL-23 and IL-17 in diagnosing disease activity was 0.911 5,which was higher than the 0.822 of HMGB1 alone,0.798 of IL-23 alone,and 0.696 of IL-17 alone(Z=3.109,Z=3.388,Z=4.674;P<0.05).Conclusion Serum HMGB1,IL-23,and IL-17 levels

关 键 词：狼疮性肾炎 疾病活动度 高迁移率族蛋白B1 白细胞介素-23 白细胞介素-17 

分 类 号：R586.3[医药卫生—内分泌]