神经精神性狼疮患者血清可溶性fractalkine、乳酸脱氢酶水平与疾病活动程度的关系及其影响因素分析

摘要 目的：探讨神经精神性狼疮（NPSLE）患者血清可溶性fractalkine（sFKN）、乳酸脱氢酶（LDH）水平与疾病活动程度的关系，分析NPSLE发病的危险因素。方法：选取2016年1月-2020年12月我院收治的106例系统性红斑狼疮患者，其中44例患者出现神经精神症状（NPSLE组），62例患者未出现神经精神症状（非NPSLE组）。检测血清sFKN、LDH水平，采用SLE疾病活动程度（SLEDAI）评分评估疾病活动程度，根据 SLEDAI评分将NPSLE组患者分为轻度组（17例）、中度组（15例）、重度组（12例）。Spearman秩相关分析血清sFKN、LDH水平与SLEDAI评分之间相关性，多因素Logistic回归分析NPSLE发病的影响因素。结果：NPSLE组血清sFKN、LDH水平、SLEDAI评分均高于非NPSLE组（P＜0.05）。重度组血清sFKN、LDH水平高于中度组和轻度组（P＜0.05），中度组血清sFKN、LDH水平高于轻度组（P＜0.05）。血清sFKN、LDH水平与SLEDAI评分均呈正相关（rs=0.868、0.732，P＜0.05）。多因素Logistic回归分析结果显示发病年龄较小、病程较短、未接受正规糖皮质激素治疗、高sFKN、高LDH是NPSLE发病的危险因素（P＜0.05）。结论：NPSLE患者血清sFKN、LDH水平均增高，高水平sFKN、LDH与NPSLE发生和疾病活动程度增加有关，临床监测血清sFKN、LDH水平有助于早期识别NPSLE。

Relationship between Serum Soluble Fractalkine And lactate Dehydrogenase Levels and Disease Activity Degree in Patients with Neuropsychiatric Systemic Lupus Erythematosus and Its Influencing Factors

ABSTRACT Objective: To investigate the relationship between serum soluble fractalkine (sFKN) and lactate dehydrogenase (LDH) levels and disease activity degree in patients with neuropsychiatric systemic lupus erythematosus (NPSLE), and to analyze the risk factors of NPSLE onset. Methods: 106 patients with systemic lupus erythematosus who were admitted to our hospital from January 2016 to December 2020 were selected, among them, 44 patients developed neuropsychiatric symptoms (NPSLE group), and 62 patients without neuropsychiatric symptoms (non-NPSLE group). The serum sFKN and LDH levels were detectd, and SLE disease activity degree (SLEDAI) score was used to evaluate disease activity degree. Patients in the NPSLE group were divided into mild group (17 cases), moderate group (15 cases) and severe group (12 cases) according to SLEDAI score. Spearman rank correlation analysis was performed to analyze the correlation between serum sFKN, LDH levels and SLEDAI score, and multivariate Logistic regression analysis was used to analyze the influencing factors of NPSLE onset. Results: The serum sFKN, LDH levels and SLEDAI score in NPSLE group were all higher than those in non-NPSLE group(P<0.05). Serum sFKN and LDH levels in severe group were higher than those in moderate group and mild group (P<0.05), and serum sFKN and LDH levels in moderate group were higher than those in mild group(P<0.05). Serum sFKN and LDH levels were positively correlated with SLEDAI score (rs=0.868, 0.732, P<0.05). Multivariate Logistic regression analysis showed that young onset age, short course of disease, not receive regular glucocorticoid therapy, high sFKN and high LDH were risk factors for the NPSLE onset(P<0.05). Conclusion: Serum sFKN and LDH levels are increased in patients with NPSLE, and high levels of sFKN and LDH are related to the occurrence of NPSLE and the increase of disease activity. Clinical monitoring of serum levels of sFKN and LDH is helpful to early identification of NPSLE.