摘要
目的:探究Toll样受体4(TLR4)、前蛋白转化酶枯草杆菌蛋白酶9(PCSK9)、氧化型低密度脂蛋白(ox-LDL)在系统性红斑狼疮(SLE)患者中的表达及其对并发颈动脉硬化(CA)的预测价值。方法:选取邢台市人民医院2017年6月至2020年5月116例SLE患者,根据有无CA分为CA组(30例)与无CA组(86例),另选择同期健康体检者58例作为健康对照组。比较3组一般资料、外周血单个核细胞(PBMC)中TLR4蛋白相对表达量、血清PCSK9、ox-LDL水平,评价PBMC中TLR4蛋白相对表达量、血清PCSK9、ox-LDL水平与系统性红斑狼疮疾病活动度(SLEDAI)评分、颈动脉内膜中层厚度(IMT)相关性,分析SLE并发CA的影响因素,受试者工作特征(ROC)曲线评价PBMC中TLR4蛋白相对表达量、血清PCSK9、ox-LDL水平对SLE并发CA的单独及联合预测价值。结果:3组BMI、IMT、TLR4蛋白相对表达量、血清PCSK9、ox-LDL水平及高血压、高脂血症发生率比较差异有统计学意义(P<0.05);CA组、无CA组SLE病程、SLEDAI评分、糖皮质激素用量差异有统计学意义(P<0.05);CA组、无CA组PBMC中TLR4蛋白相对表达量、血清PCSK9、ox-LDL与SLEDAI评分、IMT呈正相关(P<0.05);Logistic回归分析显示TLR4、血清PCSK9、ox-LDL与SLE并发CA显著相关(P<0.05);ROC曲线显示,联合预测AUC为0.919,大于TLR4蛋白相对表达量、血清PCSK9、ox-LDL水平单独预测(P<0.05)。结论:SLE患者TLR4、PCSK9、ox-LDL水平异常,尤其在并发CA患者中,上述指标异常程度更为显著,是并发CA的危险因素,联合检测可为临床评估CA发生风险提供参考。
Objective:To investigate the expression of Toll-like receptor 4(TLR4),proprotein convertase subtilisin/kexin type 9(PCSK9)and oxidizing low-density lipoprotein(ox-LDL)in patients with systemic lupus erythematosus(SLE)and their predictive value in carotid arteriosclerosis(CA).Methods:From June 2017 to May 2020,116 patients with SLE in Xingtai People’s Hospital were selected and divided into CA group(30 cases)and no-CA group(86 cases)according to the presence or absence of CA.Another58 healthy subjects were selected as healthy control group.General data,relative expression of TLR4 protein in peripheral blood mononuclear cells(PBMC),serum PCSK9 and ox-LDL levels were compared between the three groups.The relative expression of TLR4protein,serum PCSK9 and ox-LDL in PBMC were evaluated in relation to SLE disease activity(SLEDAI)score and carotid intima media thickness(IMT).The influencing factors of SLE complicated with CA were analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the relative expression of TLR4 protein in PBMC,serum PCSK9 and ox-LDL levels for the single and combined predictive value of SLE complicated with CA.Results:There were significant differences in BMI,IMT,TLR4 protein relative expression levels,serum PCSK9,ox-LDL levels and the incidence of hypertension and hyperlipidemia among 3 groups(P<0.05).There were statistically significant differences in SLE course and SLEDAI score between CA group and no-CA group(P<0.05).The relative expression of TLR4 protein,serum PCSK9,ox-LDL in PBMC of CA group and no-CA group were positively correlated with SLEDAI score and IMT(P<0.05).Logistic regression analysis showed that TLR4,serum PCSK9,ox-LDL were significantly correlated with SLE complicated with CA(P<0.05).The ROC curve showed that the AUC predicted by combination was 0.919,which was higher than that predicted by TLR4 protein relative expression level,serum PCSK9,ox-LDL level alone(P<0.05).Conclusion:The levels of TLR4,PCSK9 and ox-LDL in SLE patients are abnormal,especially in pat
作者
张素真
赵旭辉
郝世瑞
刘丹丹
ZHANG Suzhen;ZHAO Xuhui;HAO Shirui;LIU Dandan(Xingtai People’s Hospital,Xingtai 054000,China)
出处
《中国免疫学杂志》
CAS
CSCD
北大核心
2022年第9期1120-1124,共5页
Chinese Journal of Immunology
