Background. Systemic lupus erythematosus (SLE) is an autoimmune disease with strong heterogeneity, leading to variable clinical symptoms, which makes diagnosis and activity evaluation difficult. Methods. The original dataset of GSE88884 was analyzed to screen differentially expressed genes (DEGs) of SLE and the correlation between DEGs and clinical parameters (SLEDAI, anti-dsDNA, C3, and C4). The result was validated by microarray GSE121239 and SLE patients with RT-qPCR. Next, receiver operator characteristic (ROC) analysis, correlation analysis, and ordinal logistic regression were applied, respectively, to evaluate the capability of diagnosis and prediction of the candidate biomarker. Subsequently, the biological functions of the candidate biomarker were investigated through KEGG and GO enrichment, protein–protein interaction network, and the correlation matrix. Results. A total of 283 DEGs were screened, and seven of them were overlapped with SLE-related genes. DDX60 was identified as the candidate biomarker. Analyses of GSE88884, GSE121239, and SLE patients with RT-qPCR indicated that DDX60 expression level is significantly higher in patients with high disease activity. ROC analysis and the area under the ROC curve ( AUC = 0.8818 ) suggested that DDX60 has good diagnostic performance. DDX60 expression level was positively correlated with SLEDAI scores ( r = 0.24 ). For every 1-unit increase in DDX60 expression value, the odds of a higher stage of activity of SLE disease are multiplied by 1.47. The function of DDX60 mainly focuses on IFN-I-induced antiviral activities, RIG-I signaling, and innate immune. Moreover, DDX60 plays a synergistic role with DDX58, IFIH1, OASL, IFIT1, and other related genes in the SLE pathogenesis. Conclusions. DDX60 is differently expressed in SLE, and it is significantly related to both serological indicators and the disease activity of SLE. We suggested that DDX60 might be a potential biomarker for SLE diagnosis and management.

系统性红斑狼疮(systemic lupus erythema-tosus,SLE)是以致病性自身抗体和免疫复合物清除障碍为病理特征的自身免疫性疾病,临床表现为面部蝶形红斑、雷诺、脱发、紫癜等.干燥综合征(Sjogren's syndrome,SS)是一种以泪腺、唾液腺等外分泌腺受累为主的慢性自身免疫性疾病,主要病理特点是大量淋巴细胞浸润外分泌腺,临床表现以口干、眼干为主.国外研究显示,SLE患者中约有14.0％～17.8％合并SS,其大多为25岁左右发病且抗SSA抗体阳性[1].

原发性干燥综合征(primary Sjogren's syndrome, pSS)是一种主要侵犯唾液腺和泪腺的常见风湿病,我国患病率为0.29％～0.77％[1],多见于30～60岁中老年女性.pSS可能还伴随疲劳、关节疼痛、性功能障碍、睡眠障碍等症状,使得pSS患者生活质量相较于正常人严重下降,给患者带来负担[2].

[目的]从伏风角度探讨干燥综合征(Sj?gren's syndrome,SS)的病因病机与中医治疗,以期更全面地认识SS,扩宽临床诊治思路,提高临床疗效.[方法]从伏风理论的源流,风伏于五脏六腑、四肢百骸等部位而致病的过程等方面探讨伏风致病的病因病机,并结合伏风致病规律对SS的治法及用药进行论述.[结果]伏风最初源于伏邪理论,清朝刘吉人对伏风发挥最多,认为伏风可藏于孔窍、肌表、血脉及肺脾肾等脏腑,伏而化燥、动血、化瘀、成毒,并可引动内风,相兼致病,而出现类似于SS的表现,诸如口眼干燥、紫癜、泄泻、水肿等.临床论治伏风所致的SS,可从扶正兼以理气、破瘀合以拔毒等角度入手,予祛除内风、活血化瘀、益气解毒等药物.[结论]伏风理论对SS的诊疗具有重要的临床意义,根据伏风致病的过程及特点等角度来认识SS,能更全面地探究SS的本质,为治疗SS提供新思路和方法.

[目的]总结首届全国名中医范永升教授治疗系统性红斑狼疮相关肺动脉高压的学术经验.[方法]通过整理、回顾、分析范永升教授诊治系统性红斑狼疮相关肺动脉高压相关医案,从中医病因病机、治则治法、用药特色、辨证论治等方面,全面总结归纳范永升教授诊治系统性红斑狼疮相关肺动脉高压的学术经验,并列举医案1则予以佐证.[结果]范永升教授认为系统性红斑狼疮临床表现复杂多样,可出现多系统、多脏器损伤,而系统性红斑狼疮合并肺动脉高压为系统性红斑狼疮累及心、肺的特殊类型,可属于中医"五脏痹""胸痹""厥证"范畴,并认为引起系统性红斑狼疮的中医病因在于"肾虚、热毒、血瘀",其病机在于患者先天禀赋之不足,加之热毒、血瘀及痰浊等病理因素的参与,最终引起心肺受损,宗气不足,肺脉痹阻,肺气失宣,心肺气血运行不畅而导致肺动脉高压.根据本病的病因病机及临床特点分为初期气阴亏虚证,慢性期气滞血瘀证、寒凝脉络证、热毒痰瘀证和终末期阳虚脉痹证共5个证型,进行分期、分证型辨证论治,分别予以益气养阴、疏肝行气、温阳通络、解毒祛瘀、活血利水治疗.所举医案中患者处于疾病慢性期,证属寒凝脉络,治拟益气温阳、散寒通络,方用黄芪桂枝五物汤合当归四逆汤加减,临床疗效令人满意.[结论]范永升教授将系统性红斑狼疮相关肺动脉高压分为3期、5型进行辨证施治,并灵活借鉴现代医学研究成果,能改善患者临床症状,其学术经验值得同道借鉴.