系统性红斑狼疮患者外周血Zonulin检测的临床意义

Clinical Significance of Zonulin Testing in Peripheral Blood in Patients with Systemic Lupus Erythematosus

摘要: 目的：为探究外周血Zonulin在评估系统性红斑狼疮(SLE)患者肠道通透性、疾病活动度以及受累脏器的临床价值。方法：共纳入60名SLE女性患者，通过ELISA测量血清连蛋白(Zonulin)及脂肪酸结合蛋白(IFABP)水平，并收集系统性红斑狼疮疾病活动指数(SLEDAI-2k)评分及临床指标评估疾病活动度，通过线性回归和Pearson相关性评估外周血Zonulin、IFABP水平与SLEDAI-2k及临床指标之间的相关性。结果：SLE患者中外周血Zonulin (p < 0.001)及IFABP (p < 0.001)显著高于健康对照组，重度SLE患者Zonulin显著高于轻度SLE患者(p < 0.001)及中度SLE患者(p < 0.001)，且SLEDAI-2k (R² = 0.5247, p < 0.001)随着Zonulin的升高而增加。C反应蛋白、双链DNA、血沉、免疫球蛋白G与Zonulin (p < 0.001)存在正相关关系，补体C3 (p < 0.001)为负相关关系。但是，不同脏器受累患者间的外周血Zonulin及IFABP无统计学意义。结论：外周血Zonulin可能与疾病活动及加重存在一定的关系，或许可以作为SLE患者疾病严重程度及进展的潜在生物标志物，但与受累脏器及系统无关。

Abstract: Objective: To explore the clinical value of peripheral blood Zonulin in the evaluation of intestinal permeability, disease activity, and affected organs in patients with systemic lupus erythematosus (SLE). Methods: 60 female patients with SLE were enrolled. Serum levels of Zonulin and intestinal fatty acid-binding protein (IFABP) were measured by ELISA. The SLE Disease Activity Index (SLEDAI-2k) score and clinical indicators were collected to assess disease activity. Linear regression and Pearson correlation were used to evaluate the correlations between Zonulin, IFABP in peripheral blood and SLEDAI-2k, clinical indicators. Results: Compared to healthy controls, the levels of Zonulin (p < 0.001) and IFABP (p < 0.001) in peripheral blood were significantly higher in SLE patients. Zonulin levels were significantly higher in severe patients compared to both mild (p < 0.001) and moderate (p < 0.001) SLE patients. Additionally, SLEDAI-2k (R² = 0.5247, p < 0.001) increased with rising Zonulin levels. C-reactive protein, double-stranded DNA, erythrocyte sedimentation rate, and immunoglobulin G were positively correlated with Zonulin (p < 0.001), while complement C3 (p < 0.001) was negatively correlated. However, there was no statistically significant difference in Zonulin and IFABP levels in peripheral blood among patients with different organ involvements. Conclusion: Zonulin in peripheral blood may be associated with disease activity and exacerbation, potentially serving as a biomarker for the severity and progression of SLE, but it is unrelated to the involved organs and systems.