TWEAK、KIM-1及RPR与系统性红斑狼疮患儿疾病活动程度、肾损伤的相关性分析  

Correlation between TWEAK,KIM-1,RPR and disease activity,renal injury in children with systemic lupus erythematosus

作　　者：赵申[1] 李俊杰[1] ZHAO Shen;LI Junjie(Department of Pediatrics,Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Sciences,Xiangyang 441000,China)

机构地区：[1]湖北文理学院附属襄阳市中心医院儿科,襄阳441000

出　　处：《中国免疫学杂志》2025年第3期675-679,共5页Chinese Journal of Immunology

基　　金：湖北省卫生健康委员会指导性项目(WJ2019F088)。

摘　　要：目的:探讨肿瘤坏死因素样凋亡微弱诱导剂(TWEAK)、肾损伤因子1(KIM-1)及红细胞分布宽度/血小板比值(RPR)与系统性红斑狼疮(SLE)患儿疾病活动度、肾损伤的关系。方法:收集2020年2月至2022年2月襄阳市中心医院42例初诊SLE患儿(SLE组),另收集同期40例健康体检新生儿作为对照组;将SLE患儿根据系统性红斑狼疮疾病活动指数(SLEDAI)评分分为(≤9分)24例和高疾病活动度组(>9分)18例,根据是否伴有肾脏损害分为LN组31例和非LN组11例。检测所有受试对象红细胞分布宽度(RDW)和血小板计数(PLT),并计算RPR;ELISA法检测血清TWEAK、KIM-1水平。结果:SLE组血清TWEAK、KIM-1及RPR水平均显著高于对照组(P<0.05);高疾病活动度组SLE患儿血清TWEAK、KIM-1及RPR水平均显著高于低疾病活动度组(P<0.05);LN组患儿血清TWEAK、KIM-1及RPR水平均显著高于非LN组(P<0.05)。相关性分析显示,RPR与SLEDAI评分呈显著正相关(P<0.05),TWEAK、KIM-1与24 h尿蛋白呈显著正相关(P<0.05)。RPR评估SLE高疾病活动度的AUC为0.744(95%CI 0.657~0.818),显著大于TWEAK、KIM-1评估的AUC分别为0.678(95%CI:0.588~0.760)和0.598(95%CI:0.505~0.686,P<0.05);TWEAK和KIM-1预测LN的AUC分别为0.847(95%CI:0.773~0.905)和0.773(95%CI:0.690~0.842),显著大于RPR预测的AUC为0.645(95%CI:0.555~0.727,P<0.05)。结论:SLE患儿存在TWEAK、KIM-1及RPR水平变化,其中RPR对SLE疾病活动度具有较高的诊断效能,而TWEAK和KIM-1对LN预测价值较高。Objective:To explore the relationship between tumor necrosis factor-like weak inducer of apoptosis(TWEAK),kidney injury molecule 1(KIM-1),RBC distribution width/platelet ratio(RPR)and disease activity,renal injury in children with systemic lupus erythematosus(SLE).Methods:A total of 42 children with newly diagnosed SLE in Xiangyang Central Hospital were enrolled as SLE group between February 2020 and February 2022,while another 40 healthy children undergoing physical examination during the same period were enrolled as control group.According to scores of systemic lupus erythematosus disease activity index(SLEDAI),SLE children were divided into low disease activity group(≤9 points)24 cases and high disease activity group(>9 points)18 cases.According to presence or absence of renal injury,SLE children were divided into LN group 31 cases and non-LN group 11 cases.The red blood cell distribution width(RDW)and platelet count(PLT)in all objects were detected.RPR was calculated.The levels of serum TWEAK and KIM-1 were detected by ELISA.Results:The levels of serum TWEAK,KIM-1 and RPR in SLE group were significantly higher than those in control group(P<0.05).The levels of serum TWEAK,KIM-1 and RPR in high disease activity group were significantly higher than those in low disease activity group(P<0.05),which were significantly higher in LN group than non-LN group(P<0.05).Correlation analysis showed that RPR was significantly positively correlated with SLEDAI score(P<0.05),TWEAK and KIM-1 were significantly positively correlated with 24 h urinary protein(P<0.05).AUC of RPR for assessing high disease activity of SLE was 0.744(95%CI:0.657~0.818),significantly greater than that of TWEAK and KIM-1[0.678(95%CI:0.588~0.760),0.598(95%CI:0.505~0.686),P<0.05].AUC values of TWEAK and KIM-1 for predicting LN 0.847(95%CI:0.773~0.905)and 0.773(95%CI:0.690~0.842),significantly greater than that of RPR AUC values[0.645(95%CI:0.555~0.727),P<0.05].Conclusion:The levels of TWEAK,KIM-1 and RPR are changed in children with SLE.RPR has higher

关 键 词：系统性红斑狼疮 肿瘤坏死因素样凋亡微弱诱导剂 肾损伤因子1 红细胞分布宽度/血小板比值 疾病活动度 狼疮性肾炎 

分 类 号：R725[医药卫生—儿科]