Objective To investigate the serum levels of neuron-specific enolase(NSE), interleukin-18(IL-18) and 25-hydroxyvitamin D325(OH)D3 in patients with systemic lupus erythematosus(SLE), and its effects on prognosis.

Methods The peripheral blood was collected from SLE patients with different levels of activity and healthy controls, and the serum was separated.The serum levels of NSE and 25(OH)D3 were measured by chemiluminescence, and the serum IL-18 levels were measured by enzyme-linked immunosorbent assay.The relationship between their level changes and disease activity and prognosis were compared to evaluate their predictive value for prognosis.

Results The serum NSE and IL-18 levels in the observation group with stable stage and patients with mild, moderate and severe active stages were higher than those in control group, and the serum 25(OH)D3 levels were lower than those in control group(P < 0.01).The serum NSE and IL-18 levels were positively correlated with the severity of SLE(r=0.744、0.750, P < 0.01), and the serum 25(OH)D3 levels were negatively correlated with the severity of SLE(r=0.776, P < 0.01).The SLE activity index(SLEDAI-2000), serum NSE and IL-18 levels in patients with poor prognosis were significantly higher than those in patients with good prognosis(P < 0.01), and the serum 25(OH)D3 levels in patients with poor prognosis were significantly lower than those in patients with good prognosis(P < 0.01).The results of logistic regression analysis showed that the serum NSE, IL-18, 25(OH)D3 were the independent influencing factors of poor prognosis of SLE patients(P < 0.01).The AUC of the ROC curve of NSE, IL-18 and 25(OH)D3 for predicting poor prognosis of SLE patients were 0.838, 0.781 and 0.848, respectively.The AUC of combined prediction of all indicators was 0.915, which was significantly higher than the diagnostic value of each original factor alone(P < 0.01).The mean values of NSE, IL-18 and 25(OH)D3 in SLE patients were divided into the low level and high level.The risk of poor prognosis in patients with high level of NSE, IL-18 and 25(OH)D3 was 3.167 times, 6.222 times and 0.244 times higher than that in patients with low level(P < 0.05 to P < 0.01).

Conclusions The serum levels of NSE and IL-18 in SLE patients are high, the level of 25(OH)D3 is low, and their levels are related to disease activity and prognosis, which can be used as a reference index for clinical evaluation of disease activity and prognosis and adjustment of treatment plan.