硫化氢与系统性红斑狼疮的相关性研究

发布时间：2018-06-01 16:38

本文选题：硫化氢 + 硫烷硫　；参考：《新乡医学院》2017年硕士论文

【摘要】：背景系统性红斑狼疮(SLE)是一种累及多系统损害的慢性自身免疫性疾病,狼疮性肾炎(LN)是在SLE基础上出现的肾脏损害,两者发病机制主要与免疫系统异常相关。硫化氢(H_2S)为哺乳动物体内具有生物活性的气体信号分子,在多种组织器官中均有分布。已有研究报道显示H_2S在机体免疫调节中起一定作用,但关于H_2S与SLE的相关研究国内外却鲜有报道。目的本研究拟通过检测SLE患者和正常对照者血清中H_2S浓度,比较H_2S水平在SLE患者不同分组中的差异,探讨血清中H_2S与SLE疾病发生发展的相关性。方法选择2016年1月至2017年1月在河南省人民医院肾病风湿免疫科就诊的SLE患者119例,本院健康体检者27例,收集所有研究对象的血清标本和一般资料。将SLE患者依据是否伴肾损害,分为无肾损害SLE组67例、LN组52例;依据SLEDAI积分分为A组(基本无活动组)、B组(轻度活动组)、C组(中重度活动组)。分别用去蛋白法和SSP4荧光探针法检测研究对象血清中H_2S浓度。比较不同组间血清H_2S水平差异,多自变量logistic回归分析SLE疾病活动的危险因素。数据分析采用SPSS18.0软件包,以P0.05为差异有显著性。结果1.各组间年龄及性别构成比均无显著差异(P0.05)。无肾损害的SLE组患者补体C3、补体C4、血白细胞、红细胞、血红蛋白、血小板和血沉较LN组患者均无显著差异(P0.05);C-反应蛋白水平低于LN组患者,有统计学差异(P0.05)。2.两种方法检测SLE组患者血清中H_2S水平均明显低于对照组(P0.001)。LN组及无肾损害的SLE组患者血清中H_2S水平均低于对照组(P0.001)。LN组患者血清H_2S水平显著低于无肾损害的SLE组(P0.01)3.两种方法检测C组患者血清H_2S水平均显著低于A组和B组(P0.001)。去蛋白法检测B组H_2S水平与A组和对照组比较无显著差异;SSP4荧光探针法三组血清中H_2S水平均低于对照组(P0.05),B组H_2S水平低于A组(P0.001)。4.以SLE疾病是否活动为因变量,进行二元多自变量logistic回归分析显示,血清H_2S水平与SLE疾病活动呈负相关,是SLE疾病活动的独立危险因素[β=-1.257,P0.01,95%CI(0.123,0.659)]结论1.血清H_2S水平降低与SLE疾病发生发展相关,是SLE疾病活动的独立危险因素。2.SSP4荧光探针法对H_2S的检测更灵敏,选择性更高,在SLE病情分层方面更有意义。3.血清中H_2S在LN患者中显著低于无肾损害的SLE患者,提示H_2S减少可能增加SLE患者合并肾损害的风险。
[Abstract]:Background systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving multiple system damage. Lupus nephritis (LN) is a renal lesion based on SLE. The pathogenesis of these two diseases is mainly related to the abnormal immune system. H2S) is a biologically active gas signal molecule in mammals and is distributed in many tissues and organs. It has been reported that H2S plays an important role in immunomodulation, but there are few reports about H2S and SLE at home and abroad. Objective to investigate the relationship between serum H2S and the occurrence and development of SLE in patients with SLE and normal controls by comparing H2S levels in different groups of patients with SLE. Methods from January 2016 to January 2017, 119 patients with SLE were selected from the Department of Rheumatological Immunology for Nephropathy in Henan Provincial people's Hospital, and 27 patients were examined in our hospital. The serum samples and general data of all the subjects were collected. The patients with SLE were divided into 67 cases of LN group without renal damage and 52 cases of LN group according to whether they had renal damage or not. According to the SLEDAI score, they were divided into group A (basic inactive group) and group B (mild active group, group C (moderate and severe active group). The concentration of Hass in serum was detected by deproteinization and SSP4 fluorescence probe method respectively. The serum H2S levels were compared among different groups, and the risk factors of SLE disease activity were analyzed by multivariate logistic regression analysis. The data were analyzed by SPSS18.0 software package, with P0.05 as the significant difference. Result 1. There was no significant difference in age and sex ratio among groups (P 0.05). The levels of complement C3, complement C4, white blood cell, red blood cell, hemoglobin, platelet and erythrocyte sedimentation rate in SLE group without renal damage were significantly lower than those in LN group. The serum levels of H2S in the SLE group were significantly lower than those in the control group (P0.001N. LN) and the SLE group without renal damage. The serum H2S levels of the patients in the SLE group were significantly lower than those in the control group (P 0.001). The levels of H2S in the patients in the control group were significantly lower than those in the SLE group without renal damage (P 0.01). The serum H2S levels in group C were significantly lower than those in group A and group B (P 0.001). There was no significant difference in the level of H2S in group B compared with that in group A and control group. The levels of H2S in serum of three groups with SSP4 fluorescence probe method were lower than those of group B (P 0.05) and that of group B (P 0.001) .4.The level of H2S in group B was lower than that in group A (P 0.001) and that in group B was lower than that in group B (P 0.05). Taking the activity of SLE disease as dependent variable, logistic regression analysis showed that the serum H2S level was negatively correlated with the disease activity of SLE, and was an independent risk factor of SLE disease activity [尾 -1.257P0.01P0.01CI0.123C0.559] conclusion 1. The decrease of serum H2S level is related to the occurrence and development of SLE disease. It is an independent risk factor of SLE disease activity. 2. SSP4 fluorescence probe method is more sensitive and selective in the detection of H2S, and has more significance in the stratification of SLE disease. Serum H2S levels in LN patients were significantly lower than those in SLE patients without renal damage, suggesting that the decrease of H2S might increase the risk of renal damage in SLE patients.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R593.241

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