摘要
目的:探讨系统性红斑狼疮患者血清补体因子5a(C5a)、红细胞沉降率(ESR)的表达及临床意义。方法:收集119例系统性红斑狼疮患者为病例组,按照系统性红斑狼疮活动评分表(SLEDAI)分为无活动组(SLEDAI:0~4分,n=36)、轻度活动组(SLEDAI:5~9分,n=32)、中度活动组(SLEDAI:10~14分,n=27)、重度活动组(SLEDAI:≥15分,n=24);并于同期随机选取60例健康体检者为对照组。采用酶联免疫吸附法检测血清C5a水平,魏氏法检测血清ESR水平。结果:病例组血清补体C5a、ESR水平均高于对照组(P<0.05)。轻度活动组、中度活动组、重度活动组血清补体C5a、ESR水平高于无活动组,且中度活动组、重度活动组高于轻度活动组,重度活动组高于中度活动组(P<0.05)。经Pearson积矩相关分析,系统性红斑狼疮患者血清补体C5a、ESR与SLEDAI评分呈正相关关系(r=0.738、0.792,P<0.05)。绘制ROC曲线评估血清补体C5a、ESR对活动期的诊断价值,补体C5a诊断活动期的AUC为0.836(95%CI:0.777~0.895),截断值为68.23μg/ml,灵敏度、特异性分别为0.82、0.89,准确性为0.83;ESR诊断活动期的AUC为0.907(95%CI:0.863~0.951),截断值为47.65 mm/h,灵敏度、特异性分别为0.86、0.79,准确性为0.86;补体C5a联合ESR诊断活动期的AUC为0.939(95%CI:0.908~0.971),灵敏度、特异性分别为0.92、0.95,准确性为0.92。结论:血清补体C5a、ESR参与了系统性红斑狼疮的发病过程,并且与病情严重性密切相关,早期联合检测可作为临床辅助诊断系统性红斑狼疮及评估病情的重要指标。
Objective:To explore the expression of serum complement factor 5 a(C5 a) and erythrocyte sedimentation rate(ESR) in patients with systemic lupus erythematosus and its clinical significance. Methods:A total of 119 patients with systemic lupus erythematosus admitted to our hospital from February 2016 to February 2019 were selected as case group,who were divided into no activity group(SLEDAI:0 to 4 scores,n=36),mild activity group(SLEDAI:5 to 9 scores,n=32),moderate activity group(SLEDAI:10 to 14 scores,n=27) and severe activity group(SLEDAI:≥15 scores,n=27) according to the SLE disease activity index(SLEDAI). At the same time,60 healthy volunteers were randomly selected as control group. Serum C5 a level was detected by enzyme-linked immunosorbent assay,and serum ESR level was measured by the Wilson’s method. Results:The serum C5 a and ESR levels in case group were higher than those in control group(P<0.05). The serum C5 a,ESR levels in mild activity group,moderate activity group,severe activity group were higher than those in no activity group,which in moderate activity group and severe activity group were higher than those in mild activity group,and which in severe activity group were higher than those in moderate activity group(P<0.05). Pearson product moment correlation analysis showed that serum C5 a and ESR were positively associated with SLEDAI score(r=0.738,0.792,P<0.05). The ROC curve was drawn to evaluate the diagnostic value of serum C5 a and ESR in activity phase. The AUC of C5 a in activity phase was 0.836(95%CI:0.777 to 0.895),the cutoff value was 68.23 μg/ml,and the sensitivity and specificity were 0.82 and 0.89,respectively,and the accuracy was 0.83. The AUC of ESR in activity phase was 0.907(95%CI:0.863 to 0.951),the cutoff value was 47.65 mm/h,and the sensitivity and specificity were 0.86 and 0.79,respectively,and the accuracy was 0.86. The AUC of C5 a combined with ESR was 0.939(95%CI:0.908 to 0.971),and the sensitivity and specificity were 0.92 and 0.951,respectively,and the accuracy was 0.92. Conclusion:Serum C5 a and ESR are involved in the pathogenesis of systemic lupus erythematosus,which are closely related to the severity of the disease. Early detection of both C5 a and ESR can be used as important indicator for clinical diagnosis and evaluation of systemic lupus erythematosus.
作者
李赟
LI Yun(Department of Rheumatology and Immunology,The First People’s Hospital of Xining,Xining 810000)
出处
《陕西医学杂志》
CAS
2020年第1期52-55,共4页
Shaanxi Medical Journal
关键词
系统性红斑狼疮
补体C5A
红细胞沉降率
系统性红斑狼疮活动评分表
对比研究
Systemic lupus erythematosus
Complement factor 5a
Erythrocyte sedimentation rate
Clinical significance
Systemic lupus erythematosus activity score
Comparative study
