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Changes and Clinical Significance of Serum Degraded Monosaccharides in Children with Systemic Lupus Erythematosus
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摘要:
目的 探究系统性红斑狼疮(systemic lupus erythematosus, SLE)患儿血清降解单糖水平变化特征及其与病情严重程度、免疫功能紊乱的关系。 方法 回顾性收集2019年1月—2022年3月青岛大学附属医院首次确诊并住院治疗的SLE患儿及同期体检且年龄、性别与SLE患儿按1∶1比例相匹配的健康儿童临床资料。以健康儿童为对照, 分析SLE患儿血清甘露糖、氨基葡萄糖、氨基半乳糖、N-乙酰氨基葡萄糖、半乳糖5种降解单糖水平变化, 并对不同疾病活动度SLE患儿进行组内比较。采用Pearson线性相关法分析血清降解单糖水平与SLE患儿疾病活动度及免疫指标的相关性。 结果 共入选符合纳入与排除标准的SLE患儿45例(轻度疾病活动13例、中度疾病活动15例、重度疾病活动17例), 健康儿童50名。相较于健康儿童, SLE患儿血清甘露糖、氨基葡萄糖、氨基半乳糖、N-乙酰氨基葡萄糖、半乳糖水平均升高(P均＜0.05), 且血清甘露糖、N-乙酰氨基葡萄糖、半乳糖水平随疾病活动度增加而逐渐升高(P均＜0.05), 不同疾病活动度SLE患儿的氨基葡萄糖、氨基半乳糖水平均无显著差异(P均＞0.05)。Pearson相关性分析显示, 血清降解单糖水平与疾病活动度及多种免疫指标存在正相关。 结论 SLE患儿血清降解单糖水平升高且部分降解单糖水平与疾病活动度及免疫功能紊乱具有相关性。 Abstract:Objective To investigate the characteristics of changes in serum degraded monosaccharide levels in children with systemic lupus erythematosus (SLE) and its relationship with the severity of the disease and immune dysfunction. Methods Children firstly diagnosed as SLE and hospitalized in the Affiliated Hospital of Qingdao University from January 2019 to March 2022 were enrolled in the SLE group, healthy childrenwho underwent physical examination at the same period were chosen as the control and matched in a ration of 1∶1 in age and sex with the SLE group. The clinical data of both groups were collected. The serum levels of five kinds of degraded monosaccharides, which were mannose, glucosamine, aminogalactose, N-acetyl glucosamine and galactose, were analyzed in both groups. The correlations between serum levels of degraded monosaccharides and SLE disease activity and immunologic markers were analyzed with Pearson correlation coefficient. Results Totally 45 children with SLE (13 with mild disease activity, 15 with moderate disease activity, and 17 with severe disease activity) and 50 healthy children were enrolled in the experiment. Compared with the control group, the SLE group showed elevated levels of serum mannose, glucosamine, aminogalactose, N-acetyl glucosamine, and galactose (all P < 0.05); and serum levels of mannose, N-acetyl glucosamine, and galactose gradually increased with increasing disease activity (all P < 0.05). There was no significant difference in glucosamine and aminogalactose levels in children with SLE of different disease activity (all P > 0.05). Pearson correlation coefficient showed that serum degraded monosaccharide levels were positively correlated with disease activity indexes and various immunologic markers. Conclusions Serum levels of degraded monosaccharides in children with SLE are elevated and some of which are correlated with disease activity and immune dysfunction. -
Key words:
- systemic lupus erythematosus /
- serum /
- degraded monosaccharide /
- disease activity index /
- children
作者贡献：林毅负责论文构思及实验室工作；王志亮、赵海燕负责具体实验及论文初稿撰写；张丽娟负责实验技术指导；常红负责课题设计及论文审校。利益冲突：所有作者均声明不存在利益冲突 -
表 1 高效液相色谱仪分析的各项参数
指标 参数 柱温 37 ℃ 流动相 乙腈、乙酸铵缓冲溶液(pH=5.5) 流速 1 mL/min 进样体积 20 μL 时间梯度 0 min→10 min→15 min→20 min 乙腈浓度梯度 15%→22%→24%→15% 乙酸铵浓度梯度 85%→78%→76%→85% 检测波长 254 nm 参比波长 350 nm 
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表 2 SLE患儿血清降解单糖水平与疾病活动度及免疫学指标相关性分析结果(r)
指标 甘露糖 氨基葡萄糖 氨基半乳糖 N-乙酰氨基葡萄糖 半乳糖 SLEDAI评分 0.844** 0.744** 0.269 0.641** 0.649** CD3+T淋巴细胞计数 0.419 0.421 -0.318 0.222 0.366 CD4+T淋巴细胞计数 0.299 0.325 0.293 0.068 0.308 CD4+T/CD8+T淋巴细胞比值 0.544 0.495 0.406 0.349 0.315 自然杀伤细胞计数 0.597 0.351 0.377 0.560 0.628 B淋巴细胞计数 0.549** 0.682** 0.438* 0.227 0.466** IgA 0.006 0.018 0.818** -0.127 -0.006 IgE 0.430 0.406 -0.370 0.091 0.442 IgG 0.839** 0.821** 0.030 0.571 0.729* IgM -0.139 -0.212 0.345 -0.139 -0.273 C3 0.419 0.382 -0.530 0.333 0.312 C4 0.696** 0.493 -0.402 0.237 0.658** SLE：同图 2；SLEDAI：系统性红斑狼疮疾病活动指数；* P＜0.05；**P＜0.01
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