系统性红斑狼疮患者血清CRP、Cys-C、β2-MG水平及临床意义

Levels and Clinical Significance of Serum CRP, Cys-C, and β2-MG in Patients with Systemic Lupus Erythematosus

摘要

目的 分析血清C反应蛋白（CRP）、胱抑素C（Cys-C）、β2-微球蛋白（β2-MG）水平与系统性红斑狼疮（SLE）疾病活动度和肾功能的相关性,探究其对肾功能损伤的评估价值。方法 纳入鹤壁市人民医院2021年3月—2023年3月收治的102例SLE患者,设为研究组,选取同期于本院体检的健康志愿者34名,设为对照组。依据SLE疾病活动指数（SLEDAI）将患者分为无活动22例、轻度活动26例、中度活动34例、重度活动20例,比较其血清CRP、Cys-C、β2-MG水平,分析其与疾病活动度相关性。依据肾小球滤过率（eGFR）将患者分为肾功能正常患者43例、肾功能损伤患者59例,并比较血清CRP、Cys-C、β2-MG水平变化,采用受试者工作特征曲线（ROC）评价其对肾功能损伤的评估价值。结果 研究组血清CRP、Cys-C、β2-MG水平高于对照组（P<0.05）;随着疾病活动度增加,血清CRP、Cys-C、β2-MG水平呈上升趋势（P<0.05）;血清CRP、Cys-C、β2-MG与疾病活动度呈正相关（r_CRP=0.536、P=0.009;r_Cys-C=0.574、P=0.006;r_β2-MG=0.602、P=0.001）;肾功能损伤患者血清CRP、Cys-C、β2-MG水平高于肾功能正常患者（P<0.05）;血清CRP、Cys-C、β2-MG单项及联合检测评估肾功能损伤的曲线下面积（AUC）分别为0.711、0.755、0.792、0.929,且联合评估的AUC大于单独指标评估（P<0.05）。结论 SLE患者血清CRP、Cys-C、β2-MG水平升高,且与疾病活动度呈正相关,联合检测对肾功能损伤具有一定评估价值。

Abstract

Objective To analyze the correlation between serum C-reactive protein (CRP), cystatin C (Cys-C), and beta-2-microglobulin (β2-MG) levels and the disease activity and renal function of systemic lupus erythematosus (SLE), and to explore their evaluation value for renal function injury. Methods A total of 102 SLE patients admitted to our hospital from March 2021 to March 2023 were included in the study group, and 34 healthy volunteers who underwent physical examination at our hospital during the same period were included in the control group. The patients were divided into 22 cases of no activity, 26 cases of mild activity, 34 cases of moderate activity and 20 cases of severe activity according to the SLE disease activity index (SLEDAI). The serum CRP, Cys-C, and β2-MG levels were compared, and the correlation with disease activity was analyzed. According to the estimated glomerular filtration rate (eGFR), the patients were divided into 43 patients with normal renal function and 59 patients with renal function impairment, and the changes in serum CRP, Cys-C, and β2-MG levels were compared. The receiver operating characteristic curve (ROC) was adopted to evaluate its value in evaluating renal function impairment. Results The levels of serum CRP, Cys-C, and β2-MG in the study group were higher than those in the control group (P<0.05). As the disease activity increases, the levels of serum CRP, Cys-C, and β2-MG show a rising trend (P<0.05). Serum CRP, Cys-C, and β2-MG were positively correlated with disease activity （r_CRP=0.536,P=0.009;r_Cys-C=0.574,P=0.006;r_β2-MG=0.602,P=0.001）. The levels of serum CRP, Cys-C, and β2-MG in patients with renal function impairment were higher than those in patients with normal renal function (P<0.05). The area under the curve AUC of serum CRP, Cys-C, β2-MG, and their combined detection for evaluating renal function injury were 0.711, 0.755, 0.792, and 0.929, respectively, and the AUC of combined evaluation was greater than that of individual indicators (P<0.05). Conclusion The levels of serum CRP, Cys-C, and β2-MG in SLE patients are elevated and positively correlated with disease activity. Combined detection of their levels has certain evaluation value for renal function injury.

关键词

系统性红斑狼疮 / C反应蛋白 / 胱抑素C / β2-微球蛋白 / 肾功能

Key words

systemic lupus erythematosus / C-reactive protein / Cys-C / β2-microglobulin / renal function

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