血清GDF-15、TLR4水平与活动性系统性红斑狼疮的关系  

The relationship between serum GDF-15,TLR4 levels and active systemic lupus erythematosus

作　　者：陈亚林 尤再利 刁杨丽 朱薇 CHEN Yalin;YOU Zaili;DIAO Yangli;ZHU Wei(Department of Clinical Laboratory,Longchang People's Hospital,Longchang,Sichuan 642150,China)

机构地区：[1]四川省隆昌市人民医院检验科,四川隆昌642150

出　　处：《检验医学与临床》2025年第8期1050-1054,共5页Laboratory Medicine and Clinic

基　　金：四川省科技厅苗子工程项目(2021038)。

摘　　要：目的探讨血清生长分化因子-15(GDF-15)、Toll样受体4(TLR4)水平与活动性系统性红斑狼疮(SLE)的关系。方法选取2021年11月至2023年11月该院收治的120例SLE患者为观察组,另选取同期在该院体检的120例健康志愿者为对照组。根据SLE活动指数(SLEDAI)-2000评分,将SLEDAI-2000评分≥5分的患者划分为活动组,SLEDAI-2000评分<5分的患者划分为缓解组。采用Pearson相关分析SLE患者血清GDF-15、TLR4水平与补体C3、C4水平的相关性。采用多因素Logistic回归分析SLE患者发展为活动性SLE的影响因素。绘制受试者工作特征(ROC)曲线分析血清GDF-15、TLR4对活动性SLE的预测价值。结果观察组血清GDF-15、TLR4水平高于对照组,差异均有统计学意义(P<0.05)。52例患者纳入活动组,68例患者纳入缓解组。活动组补体C3、C4水平低于缓解组,血清GDF-15、TLR4水平高于缓解组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,SLE患者血清GDF-15水平与补体C3、C4水平呈负相关(r=-0.482、-0.534,P<0.05),TLR4水平与补体C3、C4水平呈负相关(r=-0.503、-0.557,P<0.05)。多因素Logistic回归分析结果显示,血清GDF-15、TLR4水平升高,补体C3、C4水平降低为SLE患者发展为活动性SLE的危险因素(P<0.05)。ROC曲线分析结果显示,血清GDF-15、TLR4及二者联合预测活动性SLE的曲线下面积(AUC)分别为0.790、0.839、0.889,二者联合预测的AUC大于血清GDF-15、TLR4单独预测的AUC(Z=2.397、2.221,P=0.017、0.026)。结论SLE患者血清GDF-15、TLR4水平升高为SLE患者发展为活动性SLE的危险因素,二者对活动性SLE具有一定的预测价值。Objective To investigate the relationship between serum growth differentiation factor-15(GDF-15),toll like receptor 4(TLR4)levels and active systemic lupus erythematosus(SLE).Methods A total of 120 SLE patients admitted to the hospital from November 2021 to November 2023 were selected as the observation group,and 120 healthy volunteers who underwent physical examination in the hospital during the same period were selected as the control group.According to SLE activity index(SLEDAI)-2000 score,patients with SLEDAI-2000 score≥5 points were divided into the active group,and those with SLEDAI-2000 score<5 points were divided into the remission group.Pearson correlation analysis was used to analyze the correlation between serum GDF-15,TLR4 levels and complement C3 and C4 levels in SLE patients.Multivariate Logistic regression analysis was used to analyze the influencing factors of SLE patients developing active SLE.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum GDF-15 and TLR4 levels in active SLE.Results The serum levels of GDF-15 and TLR4 in the observation group were obviously higher than those in the control group,and the differences were statistically significant(P<0.05).Fifty-two patients were included in the active group and 68 in the remission group.The levels of complement C3 and C4 in the active group were lower than those in the remission group,and the levels of serum GDF-15 and TLR4 in the active group were higher than those in the remission group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that serum GDF-15 level was negatively correlated with complement C3 and C4 levels in SLE patients(r=-0.482,-0.534;P<0.05),and TLR4 level was negatively correlated with complement C3 and C4 levels(r=-0.503,-0.557;P<0.05).Multivariate Logistic regression analysis showed that increased levels of serum GDF-15 and TLR4 and decreased levels of complement C3 and C4 were risk factors for the development of active SLE in patient

关 键 词：系统性红斑狼疮 生长分化因子-15 TOLL样受体4 病情严重程度 

分 类 号：R593.241[医药卫生—内科学] R446.1[医药卫生—临床医学]