血清人附睾蛋白 4 预测系统性红斑狼疮患者继发狼疮性肾炎的临床价值OA

Objective To investigating the clinical value of baseline serum human epididymis protein 4(HE4)levels in predicting lupus nephritis(LN).Methods A total of 120 diagnosed incident systemic lupus erythematosus(SLE)patients without renal involvement at Qujing Central Hospital of Yunnan Province from December 2022 to December 2025 were selected as subjects.Patients ultimately diagnosed with LN belonged to progression group(n=22),while those without LN were in non-progression group(n=98).All study subjects were followed up with serum HE4 level measurements.Logistic regression analysis was performed to identify influencing factors,and the predictive efficacy of HE4 was evaluated using a receiver operating characteristic curve.Results LN incidence rate was 18.33%.Compared to non-progressor group,SLE disease activity index(SLEDAI)scores were higher and anti-dsDNA antibody positivity rates,complement C3 and C4 levels were lower in progressor group(P<0.05).Compared to non-progressor group,erythrocyte sedimentation rate(ESR)was significantly elevated and serum albumin levels was reduced in progressor group(P<0.05).Serum HE4 levels were significantly higher in progressor group than that in non-progressor group(P<0.05).Correlation analysis revealed that baseline serum HE4 levels were positively correlated with SLEDAI score,anti-dsDNA antibody titer,and ESR,and negatively correlated with complement C3,C4,and serum albumin levels(P<0.05).The area under the curve(AUC)for serum HE4 in predicting LN was 0.828,with an optimal cut-offvalue of 53.6pmol/L.The combined model incorporating HE4,complement C3,and SLEDAI score demonstrated the best predictive performance,with an AUC of 0.875.Conclusion Elevated serum HE4 is an independent predictor of LN development in patients with incident SLE.Monitoring HE4 levels may facilitate the early identification of high-risk patients for LN.