血清铁蛋白在系统性红斑狼疮病情活动中的意义

摘要

目的 研究系统性红斑狼疮(SLE)患者血清铁蛋白(SF)的变化及临床意义.方法 研究对象为2011-01～2015-12首都医科大学附属北京世纪坛医院风湿免疫科住院治疗的SLE患者258例,按疾病活动度分为稳定期和活动期.同时选取2015-06～2015-12门诊健康体检者230名为对照组.采用化学发光法检测各组的血清SF水平,并进行统计学分析.结果 SLE患者SF显著高于对照组[(332.49±282.26)μg/L vs (81.08±46.67) μg/L,P＜0.001];且活动期患者高于静止期患者[(557.20±434.98) μg/L vs (210.27±175.88) μg/L,P＜0.001];肾脏受累患者高于无肾脏受累者[(475.26±409.33) μg/L vs(172.68±128.56)μg/L,P=0.035].SLE患者SF与ESR、抗ds-DNA抗体及SLEDAI评分均呈正相关,而与补体C3水平呈负相关.结论 SLE患者SF较健康对照组显著升高,SF与SLE病情活动性呈正相关,可作为评估SLE病情活动的有价值的实验室指标.%Objective To investigate the changes of serum ferritin (SF) levels in systemic lupus erythematosus (SLE) patients and its relationship with the disease activity.Methods A total of 258 patients with systemic lupus erythematosus,admitted to our center from January 2011 to December 2015 were selected into this study and divided into stable group (n =136) and active group (n =122) according to disease activity.And 230 healthy volunteers in our Physical Examination Center from June 2015 to December 2015 were selected as control group.The serum ferritin levels were measured by chemiluminescence in patients and controls.Results The serum ferritin levels in 258 patients with SLE were significantly higher than those in healthy controls [(332.49 ± 282.26) μg/L vs (81.08 ±46.67) μg/L,P ＜0.001].The serum ferritin levels were higher in active group than in stable group with SLE[(557.20 ±434.98) μ,g/L vs (210.27 ± 175.88) μg/L,P ＜0.001].And the serum ferritin levels were significantly higher in patients with renal involvement than that without renal involvement [(475.26 ± 409.33) μg/ml vs (172.68 ± 128.56) μg/ml,P =0.035].Moreover,the levels of serum ferritin were positively correlated with erythrocyte sedimentation rate(ESR),anti-dsDNA antibody levels,SLE disease activity index (SLEDAI) in patients with SLE,but negatively correlated with complement 3 (C3).Conclusion The serum ferritin levels in patients with SLE are significantly higher than those in normal controls.Serum ferritin levels are positively correlated with disease activity in patients with SLE.Therefore serum ferritin level can be a useful laboratory marker for the disease activity of SLE.