血清LCN2、ATG7与系统性红斑狼疮病人并发狼疮性肾炎的关系研究

马玲; 马思思; 鲍晓

血清LCN2、ATG7与系统性红斑狼疮病人并发狼疮性肾炎的关系研究

Study on the relationship between serum LCN2, ATG7 and lupus nephritis in patients with systemic lupus erythematosus

摘要

摘要:
目的： 探讨血清中性粒细胞明胶酶相关脂质运载蛋白2（LCN2）、自噬相关蛋白7（ATG7）与系统性红斑狼疮病人（SLE）并发狼疮性肾炎（LN）的相关性。
方法： 选取124例SLE病人作为研究对象（SLE组），根据病人是否并发LN，分为LN组71例和非LN组53例；另选择同期健康体检者126名作为对照组。采用ELISA检测受试者血清LCN2、ATG7水平；采用ROC曲线分析血清LCN2、ATG7对SLE并发LN的预测价值；采用多因素logistic回归分析影响SLE病人并发LN的危险因素。
结果： SLE组血清LCN2水平明显高于对照组，ATG7水平明显低于对照组（P ＜ 0.01）。LN组血清LCN2水平明显高于非LN组，ATG7水平明显低于非LN组（P ＜ 0.01）；LN组病人尿素氮、肌酐、中性粒细胞/淋巴细胞比值均明显高于非LN组（P ＜ 0.01）。多因素logistic回归分析显示，LCN2升高是SLE病人并发LN的危险因素（P ＜ 0.01），ATG7升高是SLE病人并发LN的保护因素（P ＜ 0.05）。ROC曲线分析显示，血清LCN2、ATG7单独及联合预测SLE病人并发LN的AUC分别为0.793（95% CI：0.711 ~ 0.860）、0.770（95% CI：0.686 ~ 0.841）、0.863（95% CI：0.790 ~ 0.918），二者联合预测优于LCN2、ATG7单独诊断（Z = 2.676、2.263；P ＜ 0.05）。
结论： SLE病人血清LCN2高表达、ATG7低表达，与SLE病人并发LN密切相关，并且二者对并发LN具有一定的诊断价值。

Abstract:
Objective To investigate the correlation between serum neutrophil gelatinase-associated lipocalin 2 (LCN2), autophagy-related protein 7 (ATG7), and lupus nephritis (LN) in patients with systemic lupus erythematosus (SLE).
Methods A total of 124 SLE patients were selected as the study subjects (SLE group) and divided into LN group (n = 71) and non-LN group (n = 53) based on whether the patients had concurrent LN, and 126 healthy examinees during the same period were selected as the control group. ELISA was used to detect the levels of serum LCN2 and ATG7 in the subjects, ROC curve was applied to evaluate the predictive value of serum LCN2 and ATG7 for SLE complicated with LN, and multivariate logistic regression analysis was employed to identify the risk factors for the occurrence of LN in SLE patients.
Results The serum LCN2 level in the SLE group was significantly higher than that in the control group, and the ATG7 level was significantly lower than that in the control group (P ＜ 0.01). The serum LCN2 level in the LN group was significantly higher than that in the non-LN group, and the ATG7 level was significantly lower than that in the non-LN group (P ＜ 0.01); the blood urea nitrogen, creatinine, and neutrophil/lymphocyte ratio in the LN group were significantly higher than those in the non-LN group (P ＜ 0.01). Multivariate logistic regression analysis showed that elevated LCN2 was a risk factor for the occurrence of LN in SLE patients (P ＜ 0.01), while elevated ATG7 was a protective factor for the occurrence of LN in SLE patients (P ＜ 0.05). ROC curve analysis showed that the AUC of serum LCN2 and ATG7 alone and in combination for predicting the occurrence of LN in SLE patients were 0.793 (95% CI: 0.711–0.860), 0.770 (95% CI: 0.686–0.841), and 0.863 (95% CI: 0.790–0.918), respectively. The combined prediction of LCN2 and ATG7 was superior to LCN2 and ATG7 alone (Z = 2.676, 2.263, P ＜ 0.05).
Conclusions Serum LCN2 is highly expressed and ATG7 is low expressed in SLE patients, which is closely related to the occurrence of LN in SLE patients, and both have certain diagnostic values for the occurrence of LN.

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