血清CCL19 HMGB1 IFN-γ对妊娠期系统性红斑狼疮患者围产结局预测价值

doi:10.3969/j.issn.1006-6233.2025.05.012

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摘要 目的: 分析血清趋化因子配体19(CCL19)、高迁移率蛋白-1(HMGB1)、干扰素-γ(IFN-γ)对妊娠期系统性红斑狼疮(SLE)患者围产结局预测价值。方法: 选定本院2022年1月至2024年1月就诊的180例妊娠期SLE患者,根据围产结局将其分为不良组(n=41)、良好组(n=139),另选取同期本院就诊的41例非孕期SLE患者设为对照组,比较三组血清CCL19、HMGB1、IFN-γ水平,Logistic回归分析妊娠期SLE患者不良围产结局的影响因素,受试者工作曲线(ROC)分析血清CCL19、HMGB1、IFN-γ对妊娠期SLE患者不良围产结局的预测效能。结果: 不良组血清CCL19、HMGB1、IFN-γ水平均比良好组、对照组更高(F=1184.610、180.557、487.362,P<0.05),良好组血清CCL19、HMGB1、IFN-γ水平均对照组更高(P<0.05)。Logistic回归分析显示,CCL19[OR(95%CI):2.036(1.037~4.317)]、HMGB1[OR(95%CI):1.982(1.130~3.592)]、IFN-γ[OR(95%CI):3.936(1.392~5.284)]、雷诺现象[OR(95%CI):1.818(1.057~3.269)]、SLE疾病活动评分(SLEDAI)[OR(95%CI):2.387(1.047~4.082)]是妊娠期SLE患者不良围产结局的危险因素(P<0.05)。ROC曲线分析显示,血清CCL19、HMGB1、IFN-γ联合检测预测妊娠期SLE患者不良围产结局的曲线下面积(AUC)是0.873,95%CI可信区间是0.816~0.931,血清CCL19、HMGB1、IFN-γ三项联合检测的AUC高于单项检测(Z/P=2.402/0.013、2.598/0.009、2.710/0.006)。结论: 妊娠期SLE患者血清CCL19、HMGB1、IFN-γ过度表达与不良围产结局联系密切,联合检测血清CCL19、HMGB1、IFN-γ可提高对妊娠期SLE患者不良围产结局的预测效能。

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关键词 ：系统性红斑狼疮, 趋化因子配体19, 高迁移率蛋白-1, 干扰素-γ, 妊娠, 围产结局

Abstract：Objective: To analyze the predictive value of serum chemokine ligand 19 (CCL19), high mobility protein-1 (HMGB1), and interferon - γ (IFN - γ) for perinatal outcomes in patients with systemic lupus erythematosus (SLE) during pregnancy. Methods: A total of 180 pregnant SLE patients treated in our hospital from January 2022 to January 2024 were selected and divided into an adverse group (n=41) and a good group (n=139) according to perinatal outcomes. Another 41 non-pregnant SLE patients treated in our hospital during the same period were selected as the control group. Serum levels of CCL19, HMGB1 and IFN-γ were compared between the three groups. logistic regression analysis was conducted to analyze the influencing factors of adverse perinatal outcomes in SLE patients during pregnancy, and the predictive efficacy of serum CCL19, HMGB1, and IFN-γ in SLE patients during pregnancy was analyzed by receiver operating curve (ROC). Results: Serum levels of CCL19, HMGB1 and IFN-γ in adverse group were higher than those in good group and control group (F=1184.610, 180.557, 487.362, P<0.05). Serum levels of CCL19, HMGB1 and IFN-γ in the good group were higher than those in the control group (P<0.05). Logistic regression analysis showed that, CCL19 [OR (95%CI): 2.036 (1.037~4.317)], HMGB1 [OR (95%CI): 1.982 (1.130~3.592)], IFN - γ [OR (95%CI): 3.936 (1.392~5.284)], Raynaud's phenomenon [OR (95%CI): 1.818 (1.057~3.269)], SLE disease activity score (SLEDAI)[OR (95%CI): 2.387 (1.047~4.082)] are risk factors for adverse perinatal outcomes in pregnant SLE patients (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of the combined detection of serum CCL19, HMGB1, and IFN - γ for predicting adverse perinatal outcomes in pregnant SLE patients was 0.873, with a 95% confidence interval of 0.816~0.931. The AUC of the combined detection of serum CCL19, HMGB1, and IFN - γ was higher than that of single detection (Z/P=2.402/0.013, 2.598/0.009, 2.710/0.006). Conclusion: Overexpression of serum CCL19, HMGB1, and IFN - γ in pregnant SLE patients is closely associated with adverse perinatal outcomes. Combined detection of serum CCL19, HMGB1, and IFN - γ can improve the predictive power of adverse perinatal outcomes in pregnant SLE patients.

Key words： Systemic lupus erythematosus Chemokine ligand 19 High mobility protein-1 Interferon gamma Pregnancy Perinatal outcome

基金资助:湖南省重点研发计划,(编号:2023SK2050)

通讯作者: 徐豫湘

引用本文:

符艳艳, 徐豫湘, 刘文娥. 血清CCL19 HMGB1 IFN-γ对妊娠期系统性红斑狼疮患者围产结局预测价值[J]. 河北医学, 2025, 31(5): 770-776.
FU Yanyan, XU Yuxiang, LIU Wen'e. The Predictive Value of Serum CCL19 HMGB1 IFN - γ for Perinatal Outcomes in Patients with Systemic Lupus Erythematosus during Pregnancy. HeBei Med, 2025, 31(5): 770-776.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.05.012 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I5/770

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