血清补体及IL-25在SLE中的表达及临床意义

目的 探讨血清补体（C）及IL-25在SLE累及单个或多个器官系统时的表达差异，以及血清C3、C4、总补体（CH50）、IL-25、CRP、抗双链DNA（dsDNA）抗体之间的相关性。方法 选择151例SLE患者，按SLE累及器官情况分为单纯SLE组（58例）、单器官损伤组（67例，其中狼疮性肾炎51例、血液系统损伤13例、其他器官损伤3例）和多器官损伤组（26例，其中狼疮性肾炎合并其他器官损伤25例，血液系统损伤合并脑损伤1例）。观察3组患者血清C3、C4、CH50、IL-25、CRP水平和抗dsDNA抗体阳性率间的差异，并分析各指标间的相关性。结果 3组SLE患者血清C4、CH50、IL-25、CRP水平相近， 组间血清C3水平和抗dsDNA抗体阳性率比较差异均有统计学意义（P均< 0.05）;与其他2组比较，多器官损伤组血清C3较低，抗dsDNA抗体阳性率较高（P均< 0.017）。Spearman相关性分析显示，SLE患者的C3水平与C4（r_s = 0.73，P < 0.001）、CH50（r_s = 0.81，P < 0.01）水平呈正相关，而与IL-25呈负相关（r_s = -0.14，P < 0.001）。结论 SLE患者发生多器官损伤时血清C3水平下降、抗dsDNA抗体阳性率升高，检测血清补体水平对SLE患者发生多器官损伤的预测有重要意义。

Expression and clinical significance of serum complement and IL-25 in systemic lupus erythematosus

Objective To determine the differences in the expression of serum complement （C） and IL-25 in systemic lupus erythematosus （SLE） involved with single or multi-organ systems， and analyze the correlation between serum C3， C4， CH50， IL-25， C-reactive protein （CRP） and anti-dsDNA antibody. Methods A total of 151 SLE patients were included in this study. According to the organ involvement status， all patients were divided into the SLE alone （n = 58）， SLE complicated with single organ injury （n = 67， 51 cases of lupus nephritis， 13 cases of blood system injury and 3 cases of other organ injury）， and SLE complicated with multi-organ injury groups （n = 26， 25 cases of lupus nephritis complicated with other organ injury and 1 blood system complicated with brain injury）. The levels of serum C3， C4， CH50， IL-25 and CRP， and positive rate of anti-dsDNA antibody were detected among three groups. The correlation among these indexes was analyzed. Results There was no significant difference in the C4， CH50， IL-25 and CRP levels among three groups. There were significant differences in the C3 level and positive rate of anti-dsDNA antibody among three groups （all P < 0.05）. In the multi-organ injury group， C3 level was significantly lower， whereas positive rate of anti-dsDNA antibody was significantly higher compared with those in the remaining two groups （all P < 0.017）. Spearman rank correlation test indicated that C3 level was positively correlated with C4 （r_s = 0.73， P < 0.001） and CH50 levels （r_s = 0.81， P < 0.01）， whereas negatively correlated with IL-25 level （r_s = -0.14， P < 0.001）. Conclusions In SLE patients with multi-organ involvement， serum C3 level is significantly decreased， whereas positive rate of anti-dsDNA antibody is significantly increased. Detection of serum complement levels is of clinical significance for the prediction of multi-organ injury in SLE patients.