B淋巴细胞相关细胞因子对系统性红斑狼疮疾病活动度的影响及早期肾损伤的预测价值

doi:10.3969/j.issn.1006-6233.2026.02.018

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摘要 目的: 本研究旨在探讨系统性红斑狼疮(SLE)患者中B淋巴细胞相关细胞因子水平与早期肾损伤及疾病活动度的相关性,并筛选出具有潜在临床应用价值的早期肾损伤预测标志物。方法: 研究回顾性纳入2022年2月至2024年8月期间117例SLE患者,根据是否出现早期肾损伤分为两组,并进一步对早期肾损伤组按SLE疾病活动度指数(SLEDAI)评分分层。通过单因素分析、多因素Logistic回归及ROC曲线评估细胞因子与早期肾损伤的相关性及预测价值。结果: 早期肾损伤组的SLEDAI评分、补体C3、C4水平、抗双链DNA抗体阳性率及B淋巴细胞相关细胞因子(BAFF、APRIL、IL-10、IL-21、IL-6、TNF-α、IL-17)水平均显著高于非早期肾损伤组(均P<0.05)。在早期肾损伤组中,随着SLE疾病活动度的增加,BAFF、APRIL、IL-10、IL-6、TNF-α、IL-17等细胞因子水平呈上升趋势(均P<0.05)。有序Logistic回归分析显示,BAFF、APRIL、IL-10是SLE疾病活动度升高的独立预测因子(均P<0.05);二分类Logistic回归分析显示,APRIL、TNF-α、IL-17是SLE患者发生早期肾损伤的独立危险因素,而IL-10是保护因素(均P<0.05)。ROC曲线分析表明,联合检测(APRIL、IL-10、TNF-α、IL-17)的预测价值优于单一细胞因子,ROC曲线下面积(AUC)达到0.925。结论: 本研究揭示了B淋巴细胞相关细胞因子在SLE早期肾损伤及疾病活动度中的重要作用,为早期识别高风险患者并指导精准治疗提供了新的依据。

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关键词 ：系统性红斑狼疮, 早期肾损伤, B淋巴细胞, 细胞因子

Abstract：Objective: To explore the correlation between B lymphocyte-related cytokines levels and early renal injury as well as disease activity in patients with systemic lupus erythematosus (SLE), and to screen potential predictive markers for early renal injury with clinical application value. Methods: A total of 117 SLE patients from February 2022 to August 2024 were enrolled in this retrospective study. Patients were categorized into two groups based on the presence of early renal injury, and the early renal injury subgroups were further stratified according to SLE Disease Activity Index (SLEDAI) scores. Univariate analysis, multivariate Logistic regression, and ROC curve analysis were employed to assess the correlation between cytokines and early renal injury, as well as the predictive value of these cytokines for early renal injury. Results: The SLEDAI score, complement C3 and C4 levels, positive rate of anti-double-stranded DNA antibody, and levels of B lymphocyte-related cytokines (BAFF, APRIL, IL-10, IL-21, IL-6, TNF-α, IL-17) in the early renal injury group were significantly higher than those in the non-early renal injury group (all P<0.05). In the early renal injury group, the levels of BAFF, APRIL, IL-10, IL-6, TNF-α, IL-17 and other cytokines showed an upward trend with the increase of SLE disease activity (all P<0.05). Ordinal Logistic regression analysis showed that BAFF, APRIL, and IL-10 were independent predictors of increased SLE disease activity (all P<0.05). Binary Logistic regression analysis demonstrated that APRIL, TNF-α, and IL-17 served as independent risk factors for early renal injury in SLE patients, whereas IL-10 acted as a protective factor (all P<0.05). ROC curve analysis indicated that the combined detection of APRIL, IL-10, TNF-α, and IL-17 exhibited superior predictive performance compared to individual markers, with the area under the ROC curve (AUC) achieving 0.925. Conclusion: This study reveals the important role of B lymphocyte-related cytokines in early renal injury and disease activity of SLE, offering novel evidence for the early identification of high-risk patients and the guidance of precision treatment.

Key words： Systemic lupus erythematosus Early renal injury B lymphocyte Cytokines

基金资助:湖北省自然科学基金,(编号:2025AFC133)

通讯作者: 杨惠琴

引用本文:

宗紫叶, 李树岗, 邹亮, 杨惠琴, 杨薇. B淋巴细胞相关细胞因子对系统性红斑狼疮疾病活动度的影响及早期肾损伤的预测价值[J]. 河北医学, 2026, 32(2): 287-294.
ZONG Ziye, LI Shugang, ZOU Liang, et al. The Effect of B-Lymphocyte-Associated Cytokines on Systemic Lupus Erythematosus Disease Activity and Their Predictive Value for Early Renal Damage. HeBei Med, 2026, 32(2): 287-294.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2026.02.018 或 http://www.hbyxzzs.cn/CN/Y2026/V32/I2/287

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