目的 分析血清长链非编码核糖核酸牛磺酸上调基因1(lncRNA TUG1)、微小核糖核酸-144(miR-144)表达与狼疮肾炎(LN)患者预后的关系.方法 选取2020年1月—2021年6月遂宁市中心医院风湿免疫科收治的LN患者104例为LN组,根据随访期间是否发生终末期肾病(ESRD)分为预后不良亚组36例和预后良好亚组68例,另选取同期体检健康者40例为健康对照组.采用实时荧光定量聚合酶链式反应试剂盒检测血清lncRNA TUG1、miR-144表达.经TargetScan网站预测lncRNA TUG1与miR-144的结合位点,采用Pearson相关性分析LN患者血清lncRNA TUG1与miR-144表达的相关性.多因素Logistic回归分析LN患者预后不良的危险因素,受试者工作特征(ROC)曲线分析血清lncRNA TUG1、miR-144表达对LN患者预后不良的预测价值.结果 与健康对照组比较,LN组血清 lncRNA TUG1 表达降低,miR-144 表达升高(t/P=15.885/<0.001、15.808/<0.001).经 TargetScan 网站预测,lncRNA TUG1与miR-144存在结合位点;Pearson相关性分析显示,LN患者血清lncRNA TUG1与miR-144表达呈负相关(r=-0.797,P<0.001).随访2年,104例LN患者ESRD发生率为34.62%(36/104).多因素Logistic回归分析显示,慢性肾脏病分期4期和miR-144升高为LN患者肾脏预后不良的独立危险因素[OR(95%CI)=1.197(1.062~1.349)、1.108(1.047~1.172)],诱导治疗后完全缓解和估算肾小球滤过率、lncRNA TUG1升高为独立保护因素[OR(95%CI)=0.305(0.101~0.923)、0.979(0.960~0.998)、0.841(0.750~0.943)];ROC 曲线分析显示,血清 lncRNA TUG1、miR-144表达及二项联合预测LN患者肾脏预后不良的曲线下面积(AUC)分别为0.772、0.773、0.911,二者联合预测的AUC最大(Z/P=3.239/0.001、3.247/0.001).结论 LN患者血清lncRNA TUG1低表达和miR-144高表达与肾脏预后不良有关,二者联合预测LN肾脏预后不良价值较高.
Objective To analyze the relationship between serum long-chain non-coding ribonucleic acid taurine up-regulation gene 1(lncRNA TUG1)and microribonucleic acid-144(miR-144)expression and the prognosis of LN patients with lupus nephritis(LN).Methods A total of 104 LN patients admitted to the Department of Rheumatology and Immunol-ogy of Suining Central Hospital from January 2020 to June 2021 were selected as the LN group,and they were divided into 36 subgroups with poor prognosis and 68 cases with good prognosis according to whether end-stage renal disease(ESRD)occurred during the follow-up period,and 40 healthy patients with physical examination during the same period were select-ed as the healthy control group.The expression of serum lncRNA TUG1 and miR-144 was detected by real-time quantitative polymerase chain reaction kit.The binding sites of lncRNA TUG1 and miR-144 were predicted by TargetScan,and the corre-lation between serum lncRNA TUG1 and miR-144 expression in LN patients was analyzed by Pearson correlation.Multivari-ate logistic regression analysis was used to analyze the risk factors of poor prognosis in LN patients,and receiver operating characteristics(ROC)curves were used to analyze the predictive value of serum lncRNA TUG1 and miR-144 expression in poor prognosis of LN patients.Results Compared with the healthy control group,the expression of serum lncRNA TUG1 in the LN group decreased and the expression of miR-144 increased(t/P=15.885/<0.001 and 15.808/<0.001).The Tar-getScan website predicted that there was a binding site between lncRNA TUG1 and miR-144.Pearson correlation analysis showed that serum lncRNA TUG1 was negatively correlated with miR-144 expression in LN patients(r=-0.797,P<0.001).After 2 years of follow-up,the incidence of ESRD in 104 patients with LN was 34.62%(36/104).Multivariate Logistic regres-sion analysis showed that stage 4 of chronic kidney disease and elevated miR-144 were independent risk factors for poor re-nal prognosis in patients with LN[OR(95%CI)=1.197(1.062~1349),1.108(1.047~1.172)],complete remission after induc-tion therapy and estimated glomerular filtration rate and elevated lncRNA TUG1 were independent protective factors[OR(95%CI)=0305(0.101-0.923),0.979(0.960-0.998),0.841(0.750-0.943)],ROC curve analysis showed that the expression of serum lncRNA TUG1 and miR-144 and the area under the curve(AUC)of the two combined predictions of poor renal prog-nosis in LN patients were 0.772,0.773 and 0.911,respectively,and the AUC predicted by the two was the largest(Z/P=3239/0.001、3247/0.001).Conclusion The low expression of serum lncRNA TUG1 and the high expression of miR-144 in LN patients were associated with poor renal prognosis,and the combined value of the two in predicting the poor renal prognosis of LN was higher.