系统性红斑狼疮患者血清B细胞活化因子表达水平与颈动脉粥样硬化及其相关因素的关系

方茹梦; 狄宁宁; 郑倩倩; 谢长好; 李志军

doi:10.16766/j.cnki.issn.1674-4152.002355

系统性红斑狼疮患者血清B细胞活化因子表达水平与颈动脉粥样硬化及其相关因素的关系

doi: 10.16766/j.cnki.issn.1674-4152.002355

方茹梦¹,
狄宁宁¹,
郑倩倩¹,
谢长好^{1, 2},
李志军^{1, 2, ,}

1.
蚌埠医学院第一附属医院风湿免疫科，安徽蚌埠 233004
2.
慢性疾病免疫学基础与临床安徽省重点实验室，安徽蚌埠 233004

基金项目:

安徽省自然科学基金项目 2108085MH258

详细信息

通讯作者:
李志军，E-mail：lizhijundr@126.com

中图分类号: R593.241 R543.5
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出版历程
- 收稿日期: 2021-12-08
- 网络出版日期: 2022-08-13

Relationship between serum B-cell activating factor expression and carotid atherosclerosis and its related factors in patients with systemic lupus erythematosus

1.
Department of Rheumatology and Immunology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的探索血清B细胞活化因子(BAFF)的表达水平与系统性红斑狼疮(SLE)患者颈动脉粥样硬化及其相关因素的关系。方法选择2020年10月—2021年6月入住蚌埠医学院第一附属医院风湿免疫科的符合入组标准的SLE患者103例。根据颈动脉彩色多普勒影像学检查结果将103例SLE患者分为合并动脉斑块形成组(A组，32例)、内膜增厚组(B组，31例)及动脉无器质性病变组(C组，40例)；同时选取健康人(D组，40例)的血清标本作为有关指标测定的对照组。采用酶联免疫吸附法(ELISA)检测4组血清BAFF表达水平，并分析BAFF与临床及有关实验室指标的相关性。结果 SLE患者血清中BAFF的表达水平显著高于健康对照组[5.73(2.02，7.89)ng/mL vs. 1.01(0.76，1.31)ng/mL，Z=-9.265，P＜0.001]；在SLE患者中A组BAFF表达高于B、C组[14.55(11.44，20.18)ng/mL vs. 6.33(5.81，7.45)ng/mL vs. 5.26(4.22，6.93)ng/mL，Z=55.767，P＜0.001]。相关性分析发现BAFF的表达水平与病程、年龄、SLEDAI2000、红细胞沉降率、抗dsDNA定量、IgA呈正相关关系，与补体C3呈负相关关系(r=-0.309)。结论 SLE患者血清BAFF表达水平与其颈动脉粥样硬化的发生有一定的关联性，可能是SLE患者动脉粥样硬化形成的重要促进性因素；SLE患者血清BAFF水平与SLEDAI等病情活动性指标显著相关，可作为判断病情活动性的参考指标。
- 系统性红斑狼疮 /
- 动脉粥样硬化 /
- B细胞活化因子
Abstract: Objective To explore the relationship between serum B-cell activating factor (BAFF) expression level and carotid atherosclerosis in patients with systemic lupus erythematosus (SLE) and its related factors. Methods A total of 103 SLE patients who met the inclusion criteria and were admitted to our department from October 2020 to June 2021 were selected. According to the results of carotid colour Doppler imaging, 103 SLE patients were divided into three groups: group A with arterial plaque formation (32 cases), group B with intima thickening (31 cases) and group C with no arterial disease (40 cases). At the same time, serum samples of healthy people (group D, 40 cases) were selected as the control group. The expression levels of serum BAFF in four groups were detected by enzyme-linked immunosorbent assay. The correlation between BAFF and clinical and laboratory indicators was analysed. Results The expression level of BAFF in SLE patients was significantly higher than that in healthy controls [5.73(2.02, 7.89) ng/mL vs. 1.01(0.76, 1.31) ng/mL, Z=-9.265, P < 0.001]. The expression of BAFF in SLE patients in group A was higher than that in groups B and C [14.55(11.44, 20.18) ng/mL vs. 6.33(5.81, 7.45) ng/mL vs. 5.26(4.22, 6.93) ng/mL, Z=55.767, P < 0.001]. Correlation analysis showed that the expression level of BAFF was positively correlated with the course of disease, age, SLEDAI2000, ESR, anti-dsDNA quantisation and IgA and negatively correlated with complement C3 (r=-0.309). Conclusion The expression level of serum BAFF in SLE patients is correlated with the occurrence of carotid atherosclerosis, which may be an important factor promoting the formation of atherosclerosis in SLE patients. Serum BAFF level in SLE patients was significantly correlated with SLEDAI and other disease activity indicators, which could be used as a reference indicator to judge the disease activity.
- Systemic lupus erythematosus /
- Atherosclerosis /
- B cell activating factor

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图 1 BAFF在不同SLEDAI分度下的表达

Figure 1. Expression of BAFF in different SLEDAI fractions

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表 1 3组SLE患者一般临床资料比较

Table 1. Comparison of general clinical data of SLE patients in three groups

组别	例数	年龄 [M(P₂₅, P₇₅)，岁]	性别[例(%)]		病程 [M(P₂₅, P₇₅)，月]	高脂血症 [例(%)]	IgG (x±s，g/L)	IgM (x±s，g/L)	IgA (x±s，g/L)
组别	例数	年龄 [M(P₂₅, P₇₅)，岁]	女性	男性	病程 [M(P₂₅, P₇₅)，月]	高脂血症 [例(%)]	IgG (x±s，g/L)	IgM (x±s，g/L)	IgA (x±s，g/L)
A组	32	51.50(46.00，57.00)	23(71.9)	9(28.1)	120.00(48.50，141.00)	23(71.9)	13.48±5.11	1.02±0.48	3.34±1.78
B组	31	43.00(36.00，47.00)	26(83.9)	5(16.1)	63.00(26.00，121.00)	17(54.8)	11.43±3.06	1.02±0.51	2.44±0.74
C组	40	40.00(31.25，45.75)	32(80.0)	8(20.0)	24.00(12.00，60.00)	34(85.0)	11.74±4.75	1.10±0.47	2.81±1.38
统计量		31.224^a	1.421^b		27.433^a	7.854^b	2.015^c	0.272^c	3.505^c
P值		＜0.001	0.491		＜0.001	0.020	0.139	0.762	0.034

组别	例数	C3 (x±s，g/L)	C4 (x±s，g/L)	SLEDAI 2000 (x±s)	抗dsDNA定量 [M(P₂₅, P₇₅)，g/L]	ESR [M(P₂₅, P₇₅)，mm/h]	CRP [M(P₂₅, P₇₅)，mg/L]	BAFF [M(P₂₅, P₇₅)，ng/mL]
A组	32	0.71±0.20	0.17±0.09	11.63±4.31	193(149，234)	34.00(27.25，42.50)	4.15(1.70，9.16)	14.55(11.44，20.18)
B组	31	0.84±0.13	0.16±0.05	9.61±3.51	154(85，201)	24.00(12.00，37.00)	1.76(1.56，2.32)	6.33(5.81，7.45)
C组	40	0.98±0.42	0.15±0.07	5.69±2.02	62(46，78)	17.00(9.00，26.75)	2.99(1.36，7.10)	5.26(4.22，6.93)
统计量		6.859^c	0.946^c	30.266^c	36.119^a	23.043^a	5.231^a	55.767^a
P值		0.002	0.392	＜0.001	＜0.001	＜0.001	0.103	＜0.001
注：^a为Z值，^b为χ²值，^c为F值。

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表 2 BAFF与相关临床指标的相关性

Table 2. Correlation between BAFF and related clinical indicators

项目	r值	P值
年龄(岁)	0.432	＜0.001
病程(月)	0.379	＜0.001
CPR(mg/L)	0.019	0.851
SLEDAI2000	0.528	＜0.001
ESR(mm/h)	0.409	＜0.001
IgM(g/L)	0.002	0.983
IgA(g/L)	0.249	0.011
IgG(g/L)	0.200	0.043
抗dsDNA定量(g/L)	0.419	＜0.001
补体C3(g/L)	-0.309	0.001
补体C4(g/L)	0.062	0.534

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