狼疮性肾炎患者血清TRIM...抗体和疾病活动的相关性分析_高颖颖.pdf

73现代检验医学杂志第 38 卷第 1 期2023 年 1 月J Mod Lab Med,Vol.38,No.1,Jan.2023狼疮性肾炎患者血清 TRIM27 和 FOXO1 表达水平及其与 自身免疫抗体和疾病活动的相关性分析高颖颖，李文冬，温洁，张艳琴（宝鸡市人民医院肾内科，陕西宝鸡 721000）摘要：目的分析狼疮性肾炎（lupus nephritis，LN）患者血清三结构域蛋白 27（tripartite motif-containing 27，TRIM27）和叉头转录因子 O1（forkhead transcription factor O1，FOXO1）表达水平及其与自身免疫抗体和疾病活动的相关性。方法选取宝鸡市人民医院 2020 年 6 月 2021 年 12 月收治的系统性红斑狼疮（systemic lupus erythematosus，SLE）患者 95 例，根据是否并发 LN 将其分为 LN 组（n=39）和非 LN 组（n=56），另选取同期 20 例体检健康者作为对照组；测定三组血清 TRIM27，FOXO1 水平；对 LN 组、非 LN 组血清抗 ds-DNA 抗体、抗 C1q 抗体和抗 Sm 抗体进行定性检测。根据肾脏病变活动性指数（activity index，AI）将 LN 患者分为 LN 活动组（AI 评分 6 分）和 LN 非活动组（AI 评分 6 分），比较两组血清 TRIM27，FOXO1 水平、血清抗 ds-DNA 抗体、抗 C1q 抗体和抗 Sm 抗体阳性情况及 AI 评分；Spearman 法分析 LN 患者血清 TRIM27，FOXO1 水平与自身免疫抗体阳性率、AI 评分的相关性；ROC曲线分析血清 TRIM27 和 FOXO1 水平对 LN 患者的诊断价值。结果LN 组血清 TRIM27 水平高于非 LN 组、对照组（87.635.28pg/ml vs 78.825.43pg/ml，42.565.19pg/ml），血清 FOXO1 水平低于非 LN 组、对照组（348.3612.36ng/l vs 367.1512.19ng/l，396.2812.82ng/l），差异有统计学意义（F=492.090，100.024，均 P0.05）；LN 组血清抗 ds-DNA 抗体、抗 C1q 抗体和抗 Sm 抗体阳性率高于非 LN 组（56.41%vs 35.71%，48.72%vs 28.57%，38.46%vs 19.64%），差异均有统计学意义（2=3.992，4.010，4.096，均 P0.05）。LN 活动组血清 TRIM27 水平、AI 评分高于LN 非活动组（92.518.92pg/ml vs 85.193.46pg/ml，9.502.26 分 vs 3.001.15 分），血清 FOXO1 水平低于 LN 非活动组（341.5212.78ng/l vs 351.7812.15ng/l），血清抗 ds-DNA 抗体、抗 C1q 抗体和抗 Sm 抗体阳性率高于 LN非活动组（84.62%vs 42.31%，76.92%vs 34.62%，61.54%vs 26.92%），差异均有统计学意义（t=3.701，11.983，2.444;2=0.012，0.013，0.036，均 P0.05）。LN 患者血清 TRIM27 水平与血清抗 ds-DNA 抗体、抗 C1q 抗体和抗 Sm 抗体阳性率和 AI 评分均呈正相关（r=0.516，0.426，0.458，0.697，均 P0.05），而血清 FOXO1 水平与之均呈负相关（r=-0.613，-0.572，-0.482，-0.503，均P0.05）。ROC曲线显示，与血清TRIM27曲线下面积（area under curve，AUC）（AUC=0.822，95%CI:0.7400.903），FOXO1（AUC=0.804，95%CI:0.7160.893）单项诊断相比，二者联合检测（AUC=0.899，95%CI:0.8400.958）对 LN 的诊断价值较高（Z=1.698，0.079，均 P0.05）。结论LN 患者血清 TRIM27 高表达、FOXO1 低表达均与自身免疫抗体阳性率和 AI 评分相关，对 LN 患者有一定诊断价值。关键词：狼疮性肾炎；三结构域蛋白 27；叉头转录因子 O1；疾病活动；自身免疫抗体中图分类号：R593.242；R392.11文献标识码：A文章编号:1671-7414（2023）01-073-05doi:10.3969/j.issn.1671-7414.2023.01.014Expression of TRIM27 and FOXO1 in Serum of Patients with Lupus Nephritis and Their Correlation with Autoimmune Antibodies and Disease ActivityGAO Ying-ying,LI Wen-dong,WEN Jie,ZHANG Yan-qin(Department of Nephrology,Baoji Peoples Hospital，Shaanxi Baoji 721000,China)Abstract:ObjectiveTo analyze theexpression of tripartite motif-containing 27(TRIM27)and for khead transcription factor O1(FOXO1)in serum of patients with lupus nephritis(LN)and their correlation with autoimmune antibodies and disease activity.MethodsThe 95 cases of systemic lupus erythematosus(SLE)patients admitted to Baoji Peoples Hospital from June 2020 to December 2021 were selected,and they were divided into LN group(n=39)and non-LN group(n=56)according to whether they had concurrent LN or not.In addition,20 healthy people who underwent physical examination were gathered as the control group.The levels of serum TRIM27 and FOXO1 in three groups were determined.Anti-ds-DNA antibody,anti-C1q antibody and 基金项目：陕西省自然科学基础研究计划项目，项目编号：S2019-JC-YB-1405。作者简介：高颖颖（1992-），女，硕士研究生，副主任医师，研究方向：肾脏病及血液净化，E-mail:。通讯作者：张艳琴（1983-），女，本科，副主任医师，研究方向：慢性肾病、血液透析的临床研究与诊治，E-mail:。74现代检验医学杂志第 38 卷第 1 期2023 年 1 月J Mod Lab Med,Vol.38,No.1,Jan.2023anti-Sm antibody in serum of LN group and non-LN group were qualitatively detected.According to the nephropathy activity index(AI),LN patients were divided into LN active group(AI score 6 points)and LN inactive group(AI score 6 points),the serum TRIM27 and FOXO1 levels,serum anti-ds-DNA antibody,anti-C1q antibody,anti-Sm antibody positive status and AI score were compared between the two groups.Spearman method was used to analyze the correlation of serum TRIM27 and FOXO1 levels with autoimmune antibody positivity and AI score in LN patients.The diagnostic value of serum TRIM27 and FOXO1 levels in patients with LN was analyzed by ROC curve.ResultsThe level of serum TRIM27 in LN group was higher than that in non-LN group and control group(87.635.28pg/ml vs 78.825.43pg/ml,42.565.19pg/ml),and the level of serum FOXO1 was lower than that in non-LN group and control group(348.3612.36ng/l vs 367.1512.19ng/l,396.2812.82ng/l),the differences were statistically significant(F=492.090,100.024,all P0.05).The positive rates of serum anti-ds-DNA antibody,anti-C1q antibody and anti-Sm antibody in the LN group were higher than those in the non-LN group（56.41%vs 35.71%，48.72%vs 28.57%，38.46%vs 19.64%）,the differences were statistically significant(2=3.992,4.010,4.096,all P0.05).The level of serum TRIM27 and AI score in the LN active group were higher than those in the LN inactive group(92.518.92pg/ml vs 85.193.46pg/ml,9.502.26 scores vs 3.001.15 scores),the level of serum FOXO1 was lower than that in the LN inactive group(341.5212.78ng/l vs 351.7812.15ng/l),the positive rates of serum anti-ds-DNA antibody,anti-C1q antibody and anti-Sm antibody in the LN active group were higher than those in the LN inactive group（84.62%vs 42.31%，76.92%vs 34.62%，61.54%vs 26.92%）,the differences were statistically significant(t=3.701,11.983,2.444,2=0.012,0.013,0.0