抗C1q抗体对狼疮肾炎患者的诊断意义.docVIP

抗C1q抗体对狼疮肾炎患者的诊断意义 作者：金卫东 俞晓洁 贾敬年 周永列 【摘要】 目的 探讨抗C1q抗体与系统性红斑狼疮(System lupus erythematosus ，SLE)活动性的关系以及在狼疮肾(lupus nephritis ,LN)患者血清的表达及临床意义。 方法 采用酶联免疫吸附试验对33例LN患者血清进行检测，并与43例无肾炎临床表现的SLE患者作为对照组。同时将76例SLE患者按SLEDAI评分分为SLEDAI≥10分组和SLEDAI10分组两组，进行抗C1q抗体与SLE活动度相关性的 分析 。 结果 LN患者血清中抗C1q抗体浓度及阳性率显著高于SLE对照组(P0.01)。同时SLEDAI≥10分组，抗C1q抗体浓度及阳性率显著高于SLEDAI10分组 (P0.01)。相关性分析表明血清中抗C1q抗体与SLEDAI评分呈正相关。分别以LN和SLEDAI作为因变量将抗C1q抗体，抗dsDNA抗体，抗Sm抗体，抗nRNP抗体进行Logistic回归统计分析。结果显示以LN作为因变量入选的自变量有抗C1q抗体，抗Sm抗体（P0.05），以SLEDAI作为因变量入选的自变量抗C1q抗体（P0.05）。 结论 在LN患者中，存在着抗C1q抗体的高表达，抗C1q抗体在LN疾病中起较为重要作用。 抗C1q抗体是反映SLE患者并发肾脏损伤的重要指标，在LN诊断和判定其活动性方面有重要作用，与SLE的发生 发展 密切相关,能较好的反映SLE病情的活动性。 【关键词】 抗C1q抗体 抗dsDNA抗体 抗Sm抗体 系统性红斑狼疮 狼疮性肾炎 　　【Abstract】 Objective To explore the expression of anti- C1q antibodies as well as thEir clinical significance in patients with lupus nephritis(LN) . Methods ELISA assay was performed to examine anti- C1q antibodies in the serum of 33 patients with LN and 43 patients of systemic lupus erythematosus without renal damage. The n divided all the 76 patients into two groups by SLEDAI score to analyze the correlation between the level of anti-C1q antibodies and activity of disease. Results Anti-C1q antibodies was significantly higher in LN than in control (P0.01). The positive rate of anti- C1q antibodies was significantly higher in LN than in the control .There was significant and positives correlation between the level of anti-C1q antibodies and SLEDAI score (P0.01). The laboratory tests also showed that the positive rate of anti-dsDNA, anti-Sm, anti- nRNP was higher in the LN than in the control groups (P0.01). In multivariate analysis the factors associate with LN and SLEDAI were anti-C1q antibodies, anti-Sm antibodies. Conclusions In patients with LN ,anti- C1q antibodies are significantly higher than that in control groups. anti- C1q antibodies playsa role as diagnostic tools of LN. anti- C1q antibodies is also closely related in the pathogenesis of SLE. They can reflect the activity o