白三烯B4水平与系统性红斑狼疮患者T淋巴细胞亚群的关系及对感染风险的预测OA
Relationship between leukotriene B4 level and T lymphocyte subsets in systemic lupus erythematosus patients and their prediction of infection risk
目的:探究白三烯B4(LTB4)水平与系统性红斑狼疮(SLE)患者T淋巴细胞亚群的关系及对感染风险的预测.方法:选择2021年5月至2024年10月于沧州市中心医院就诊的SLE患者(n=156)为研究对象.根据是否合并感染,分为感染组(n=65)和无感染组(n=91).采用多因素Logistic回归分析危险因素,并计算危险因素比值比(OR).采用线性回归分析相关性.采用限制性立方样条(RCS)分析剂量反应关系.采用受试者工作特征(ROC)曲线分析预测价值.采用非条件Logistic回归模型及计算表分析交互作用.结果:SLE合并感染常见的感染部位为呼吸道(71.79%)、胃肠道(18.59%)和泌尿道(12.82%),常见的感染病原体为细菌(59.62%)、真菌(12.18%)和病毒(10.26%).多因素分析显示,SLEDAI评分、Hb、ALB、CRP、LTB4、CD4+T细胞、CD8+T细胞均为SLE合并感染的独立影响因素(P<0.05).亚组分析显示,在不同混杂因素下,LTB4水平与SLE合并感染的相关性稳定存在,且亚组间不存在交互作用(P趋势<0.05,P交互>0.05).线性回归分析显示,LTB4与总T细胞、CD4+T细胞、CD8+T细胞均呈负相关(β<0,P<0.05),与CD4+T/CD8+T呈正相关(β>0,P<0.05);在调整一系列混杂因素后仍具有显著相关性(P<0.05).RCS分析显示,LTB4水平与SLE合并感染风险存在非线性关系(非线性检验P<0.001).ROC曲线分析显示,LTB4预测SLE合并感染的曲线下面积(AUC)为0.892(95%CI:0.842～0.942).交互作用分析显示,LTB4水平(≥315.80 pg/mL)与CD4+T细胞(<396.88 个/µL)、CD8+T细胞(<364.50 个/µL)对SLE合并感染存在相加交互作用(P<0.05).结论:LTB4水平与SLE患者T淋巴细胞亚群存在显著相关性,且是SLE合并感染的独立影响因素.LTB4水平与CD4+T细胞、CD8+T细胞对SLE合并感染风险具有相加交互作用.
Objective:To explore the relationship between leukotriene B4(LTB4)level and T lymphocyte subsets in systemic lupus erythematosus(SLE)patients,and predicting the risk of infection.Methods:SLE patients(n=156)who visited Cangzhou Central Hospital from May 2021 to October 2024 were selected as research subjects.According to whether there were co-infections,they were divided into infected group(n=65)and non infected group(n=91).Multiple Logistic regression was used to analyze risk factors and calculate the odds ratio(OR)of risk factors.Linear regression was used to analyze the correlation.Restricted cubic splines(RCS)was used to analyze dose-response relationships.Receiver operating characteristic(ROC)curve was used to analyze the predictive value.Unconditional Logistic regression model and calculation table were used to analyze the interaction effects.Results:Common infection sites of SLE combined infections were the respiratory tract(71.79%),gastrointestinal tract(18.59%)and urinary tract(12.82%),and the common pathogens of infection were bacteria(59.62%),fungi(12.18%)and viruses(10.26%).Multiple factor analysis showed that SLEDAI score,Hb,ALB,CRP,LTB4,CD4+T cells and CD8+T cells were independent influencing factors for SLE co infec-tion(P<0.05).Subgroup analysis showed that there was a stable correlation between LTB4 levels and SLE co infection under different confounding factors,and there was no interaction between subgroups(Ptrend<0.05,Pinteraction>0.05).Linear regression analysis showed that LTB4 was negatively correlated with total T cells,CD4+T cells,CD8+T cells(β<0,P<0.05),and positively correlated with CD4+T/CD8+T(β>0,P<0.05);after adjusting for a series of confounding factors,there was still a significant correlation(P<0.05).RCS analysis showed a non-linear relationship between LTB4 level and the risk of SLE co-infection(nonlinear test P<0.001).ROC curve analysis showed that LTB4 predicted an area under curve(AUC)of 0.892(95%CI:0.842～0.942)for SLE co-infection.Interaction analysis showed that there was an additive interaction between LTB4 level(≥315.80 pg/mL)and CD4+T cells(<396.88 cells/µL),CD8+T cells(<364.50 cells/µL)in SLE co-infection(P<0.05).Conclusion:There is a significant correlation between LTB4 level and T lymphocyte subsets in SLE patients,and it is an independent influencing factor for SLE co-infection.Level of LTB4 has an additive in-teraction with CD4+T cells and CD8+T cells on the risk of SLE co-infection.
李艳霞;庞杰;张宗芳;李静;左艳华
沧州市中心医院风湿免疫科,沧州 061000沧州市中心医院风湿免疫科,沧州 061000沧州市中心医院风湿免疫科,沧州 061000沧州市中心医院风湿免疫科,沧州 061000沧州市中心医院风湿免疫科,沧州 061000
医药卫生
系统性红斑狼疮白三烯B4T淋巴细胞亚群感染
Systemic lupus erythematosusLeukotriene B4T lymphocyte subsetsInfection
《中国免疫学杂志》 2026 (3)
547-554,8
河北省医学科学研究课题计划项目(20251550).
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