中文摘要：

目的系统性红斑狼疮(SLE)是一种累及多系统、多器官的自身免疫性疾病,存在动脉粥样硬化的风险。单核细胞CD36的表达与动脉粥样硬化形成相关。因此,本研究探讨单核细胞CD36表达与SLE患者颈动脉斑块形成的关系。方法选取本院就诊的178例SLE患者,根据超声检查结果分为有动脉粥样硬化的SLE患者和无动脉粥样硬化的SLE患者。采用流式细胞术检测单核细胞CD36的表达。采用Logistic回归分析分析与患者动脉粥样硬化形成的关系,ROC曲线评价相关指标对于动脉粥样硬化斑块形成的评估价值。结果 SLE患者中,存在动脉粥样斑块和无动脉粥样斑块的SLE患者比较结果显示,两组患者病程、高血压、C反应蛋白(CRP)、总胆固醇(TC)以及CD36的平均荧光强度存在统计学差异(P<0.05)。在有动脉粥样硬化斑块形成的SLE患者中,单核细胞CD36的平均荧光强度和CRP和颈部动脉粥样硬化斑块厚度(c IMT)呈明显负相关(r=-0.378,P=0.001;r=-0.277,P=0.013)。在逐步Logistic回归分析中,病程、高血压、CRP和单核细胞CD36平均荧光强度与SLE患者动脉粥样硬化形成相关。ROC曲线分析结果显示,单核细胞CD36荧光强度对动脉粥样硬化患者评估价值的曲线下面积为0.840(95%CI:0.783~0.893;P<0.001),敏感度为83.7%,特异度为62.5%。结论本次研究证实,单核细胞CD36在伴有动脉粥样斑块的SLE患者中表达下调,且与c MIT负相关,外周血单核细胞CD36的低表达可能作为SLE患者动脉粥样硬化形成的风险因素。

英文摘要：

Objective Systemic lupus erythematosus (SLE) is an autoimmune disease involving in multiple systems with the risk of atherosclerosis (AS). The expression of monocyte CD36 is associated with AS. Therefore, the aim of this study investigated the association between monocyte CD36 expression and carotid artery plaque in patients with SLE. Methods A total of 130 SLE patients were divided into AS and non-AS group according to ultrasound examination. Using flow cytometry to detect the expression of monocyte CD36 in patients with SLE. Logistic regression analysis was used to identify risk factors associated AS in patients with SLE, using ROC curve to evaluate performance of related index. Results Disease duration, hypertension, CRP, TC and monocyte CD36 expression had statistical differences in SLE patients with AS compared with patients without AS (P<0.05). In SLE patients with AS, monocyte CD36 fluorescence intensity was negatively correlated with CRP and carotid artery wall intima-media thickness (cMIT) (r=-0.378, P=0.001; r=-0.277, P=0.013). In stepwise Logistic regression analysis, disease duration, hypertension, CRP and monocyte CD36 fluorescence intensity were associated with SLE patients with AS. The area under the curve of monocyte CD36 fluorescence intensity was 0. 840 (95% CI 0.783 to 0.893, P<0.001), with the sensitivity of 83.7%, and specificity of 62.5% in ROC curve analysis. Conclusions This study showed the monocyte CD36 was reduced in SLE patients with AS, and it was negative correlated with cMIT, which peripheral monocyte CD36 expression may be a risk factor for atherosclerosis formation in patients with SLE.