红细胞C4d与补体受体1比值分析：用于鉴别发热的系统性红斑狼疮患者的感染与病情复发

Analysis of Erythrocyte C4d to Complement Receptor 1 Ratio: Use in Distinguishing between Infection and Flare-Up in Febrile Patients with Systemic Lupus Erythematosus.

作者信息

Chen Chen-Hung, Tai Shun-Ban, Chen Hsiang-Cheng, Yang Deng-Ho, Peng Ming-Yieh, Lin Yuh-Feng

机构信息

Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei 11031, Taiwan ; Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, School of Medicine, Tzu Chi University, Hualien 970, Taiwan ; Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.

Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Armed-Forces Zuoying General Hospital, Kaohsiung 81342, Taiwan.

出版信息

Biomed Res Int. 2015;2015:939783. doi: 10.1155/2015/939783. Epub 2015 Jul 26.

DOI:10.1155/2015/939783

PMID:26273660

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4529962/

Abstract

OBJECTIVE

Fever in systemic lupus erythematosus (SLE) can be caused by infection or flare-up of the disease. This study aimed to determine whether the ratio of the level of erythrocyte-bound C4d to that of complement receptor 1 (C4d/CR1) can serve as a useful biomarker in the differentiation between infection and flare-up in febrile SLE patients.

METHODS

We enrolled febrile SLE patients and determined the ratio on the day of admission. The patients were divided into 2 groups according to the subsequent clinical course.

RESULTS

Among the febrile SLE patients, those with flare-up had higher ratios and lower C-reactive protein (CRP) levels than those with infection. Cut-off values of <1.2447 and >4.67 for C4d/CR1 ratio and CRP, respectively, were 40.91% sensitive and 100.0% specific for the presence of infection in febrile SLE patients; similarly, cut-off values of >1.2447 and <2.2, respectively, were 80% sensitive and 100% specific for the absence of infection in febrile SLE patients.

CONCLUSION

The C4d/CR1 ratio is a simple and quickly determinable biomarker that enables the differentiation between infection and flare-up in febrile SLE patients at initial evaluation. Further, when combined with the CRP level, it is useful to evaluate disease activity in SLE patients with infection.

摘要

目的

系统性红斑狼疮（SLE）患者发热可能由感染或疾病复发引起。本研究旨在确定红细胞结合C4d水平与补体受体1水平之比（C4d/CR1）能否作为发热SLE患者区分感染与疾病复发的有用生物标志物。

方法

我们纳入了发热SLE患者，并在入院当天测定该比值。根据后续临床病程将患者分为两组。

结果

在发热SLE患者中，疾病复发组的C4d/CR1比值高于感染组，而C反应蛋白（CRP）水平低于感染组。C4d/CR1比值<1.2447和CRP>4.67的临界值对发热SLE患者感染存在的敏感性为40.91%，特异性为100.0%；同样，C4d/CR1比值>1.2447和CRP<2.2的临界值对发热SLE患者无感染的敏感性为80%，特异性为100%。