2023 年第 10 期 第 18 卷

血浆白细胞介素8在系统性红斑狼疮合并肾损伤和增殖性狼疮性肾炎诊断中的价值

Value of plasma interleukin-8 in the diagnosis of systemic lupus erythematosus with renal injury and proliferative lupus nephritis

作者：韩立沛赵亚飞齐媛媛赵占正

英文作者：Han Lipei Zhao Yafei Qi Yuanyuan Zhao Zhanzheng

单位：郑州大学第一附属医院肾内科，郑州450052

英文单位：Department of Nephrology the First Affiliated Hospital of Zhengzhou University Zhenzhou 450052 China

关键词：系统性红斑狼疮；狼疮性肾炎；白细胞介素8；生物标志物

英文关键词：Systemiclupuserythematosus;Lupusnephritis;Interleukin-8;Biomarker

• 摘要：

• 目的  探讨血浆白细胞介素8（IL-8）在系统性红斑狼疮（SLE）合并肾损伤和增殖性狼疮性肾炎（LN）诊断中的价值。方法  选取2019年7月1日至12月31日于郑州大学第一附属医院就诊的63例SLE患者，其中51例诊断为LN（50例经肾活检诊断，增殖性LN 12例，非增殖性LN 38例），另外招募了21名健康个体作为对照组。收集患者临床资料，检测受试者血浆IL-8水平。采用受试者工作特征（ROC）曲线分析血浆IL-8对SLE合并肾损伤和增殖性LN的诊断价值。采用Logistic回归方法分析血浆IL-8水平识别活动性LN的潜力。采用Spearman相关性分析方法分析血浆IL-8与其他临床指标的相关性。结果  63例SLE患者根据是否有肾脏受累分为不伴LN组（12例）和伴LN组（51例）。伴LN组血浆IL-8水平高于不伴LN组和对照组［0.442(0.224,0.979)ng/L比0.247(0.017,0.380)、0.120(0.001,0.259)ng/L］(均P＜0.05)。血浆IL-8水平区分SLE伴LN与不伴LN的曲线下面积（AUC）为0.708(95%置信区间：0.568～0.847，P=0.026)。增殖性LN患者血浆IL-8水平明显高于非增殖性LN患者（P=0.049）。血浆IL-8水平识别增殖性LN的AUC为0.690(95%置信区间：0.528～0.851)。多元Logistic回归分析结果显示，血浆IL-8水平能较好地预测活动性LN（P＜0.05）。LN患者血浆IL-8水平与血尿素氮、血肌酐、抗双链DNA抗体、系统性红斑狼疮疾病活动性指数评分呈显著正相关，与白细胞计数、估算肾小球滤过率、血清白蛋白、补体C3水平呈显著负相关（均P＜0.05）。结论  血浆IL-8可以识别肾脏受累的SLE患者，并反映疾病活动性和肾功能。血浆IL-8水平与肾损伤有一定相关性。此外，它可以用于区分增殖性LN患者与非增殖性LN患者。因此，血浆IL-8可能是LN的一个有价值的生物标志物。

• Objective  To explore the value of plasma interleukin-8 (IL-8) in the diagnosis of systemic lupus erythematosus (SLE) with renal injury and proliferative lupus nephritis (LN). Methods  From July 1 to December 31, 2019, 63 patients with SLE admitted to the First Affiliated Hospital of Zhengzhou University were selected, of which 51 cases were diagnosed as LN (50 cases were diagnosed by renal biopsy, including 12 cases of proliferative LN and 38 cases of non-proliferative LN), and another 21 healthy individuals were recruited as the control group. The clinical data of patients were collected, and the plasma IL-8 levels of subjects were detected. The diagnostic value of plasma IL-8 for SLE with renal injury and proliferative LN was analyzed by the receiver operating characteristic (ROC) curve. Logistic regression method was used to analyze the potential of plasma IL-8 level to identify active LN. Spearman correlation analysis method was used to analyze the correlation between plasma IL-8 and other clinical indicators. Results  According to whether they had kidney involvement, 63 patients with SLE were divided into group without LN (12 cases) and group with LN (51 cases). The plasma IL-8 level in group with LN was higher than that in the control group and group without LN ［0.442(0.224,0.979) ng/L vs 0.247(0.017,0.380), 0.120(0.001,0.259)ng/L］ (both P＜0.05). The area under the curve (AUC) of plasma IL-8 level to distinguish SLE with LN and without LN was 0.708 (95% confidence interval: 0.568-0.847, P=0.026). The plasma IL-8 level in patients with proliferative LN was significantly higher than that in patients with non-proliferative LN (P=0.049). The AUC of plasma IL-8 level recognizing proliferative LN was 0.690 (95% confidence interval: 0.528-0.851). The results   of multiple Logistic regression analysis showed that the plasma IL-8 level could better predict the active LN (P＜0.05). The level of plasma IL-8 in patients with LN was significantly positively correlated with blood urea nitrogen, blood creatinine, anti-double stranded DNA antibody and systemic lupus erythematosus disease activity index score, and negatively correlated with leukocyte count, estimated glomerular filtration rate, serum albumin and complement C3 level (all P＜0.05). ConclusionsPlasma IL-8 can identify the patients with SLE and renal involvement and reflect disease activity and renal function. There is a certain correlation between the plasma IL-8 level and renal injury. In addition, it can distinguish between the patients with proliferative LN and the patients with non-proliferative LN. Therefore, plasma IL-8 may be a valuable biomarker for LN.