白介素-18与可溶性Fas在狼疮肾炎进展中的关联性研究

目的：评估狼疮肾炎（LN）患者白介素-18（IL-18）与可溶性Fas（sFas）的相关性，为临床评估疾病进展提供参考。方法：按照纳入标准并排除其它主要脏器发生病变的患者，32名蛋白尿LN患者（病例组）和46名肾脏及其它主要脏器未发生损伤的系统性红斑狼疮（SLE）患者（对照组）纳入了研究。酶联免疫吸附测定IL-18和sFas水平。Pearson和Spearman相关性分析两者关系；多因素Logistic回归分析SLE患者蛋白尿的预测因素。结果：两组患者的系统性红斑狼疮病情活动指数（SLEDAI）评分（肾炎相关项目评分除外）比较，差异无统计学意义（P〉0．05）。病例组（LN患者）血液中sFas（P=0．03）和IL-18（P=0．02）浓度均高于对照组（无蛋白尿轻度SI，E患者）。sFas与IL-18（r=0．5，P〈0．001）在LN患者中的关联强度高于两者在轻症SLE患者中的关联性（r=0．4，P〈0．001）。多因素分析结果显示，sFas是LN患者蛋白尿的预测因子。结论：LN患者的sFas和IL-18水平高于无肾脏损伤的SLE患者，而两者之间的相关性前者也强于后者。两者在SLE患者肾脏损伤中的具体作用尚需进一步深入研究。

Correlation between interleukin 18 and soluble Fas in progression of upus nephritis

Objective- To evaluate the correlation between interleukin-18 （IL-18） and soluble Fas （sFas） in patients with lupus nephritis （LN）. Methods; According to the inclusion criteria, patients with other major organs lesions were excluded, and 32 patients with LN proteinuria （ case group ） and 46 sys- temic lupus erythematosus （SLE） patients without kidney or other major organs damage were enrolled （control group）. Interleukin-18 （IL-18） and soluble Fas （sFas） were detected with Enzyme Linked Immu- no Sorbent Assay. Pearson and Spearman correlation analysis were applied to anlyasis the relationship be- tween the two. Results. No significant difference in systemic lupus erythematosus disease activity index （SLEDAI） score was found between the two groups; Case group showed higher blood sFas level （P= 0.03）and IL-18 （P=0.02） concentrations than the control group. The correlation between sFas and IL-18 was stronger in the case group （r=0.5, P〈0. 001） than that in control group （r=0.4, P〈0. 001）. Mul- tivariate analysis showed sFas proteinuria is a predictor of LN. Conclusion.. sFas and IL-18 levelsc in LN patients were significantly higher than SLE patients without kidney damage; and the correlation between the two indicators are significantly stronger in LN patients that that in SLE patients. Their roles in kidney damage in SLE patients requires further in-depth study.