抗C1q抗体对狼疮肾炎患者的诊断意义

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SLEDAI<10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(P<0.01)。同时SLEDAI≥10分组,抗C1q抗体浓度及阳性率显著高于SLEDAI<10分组(P<0.01)。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(P<0.05),以SLEDAI作为因变量入选的自变量抗C1q抗体(P<0.05)。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。

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. Then divided all the 76 patients into two groups by SLEDAI score to analyze the correlation between the level of anti- C1q antibedies and activity of disease. Results Anti - C1q antibodies was significantly higher in LN than in control （ P 〈 0.01） . The pesitive 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 arm SLEDAI score （ P 〈0. 01 ）. The laboratory tests also showed that the positive rate of anti - dsDNA, anti - Sin, anti - nRNP was higher in the LN than in the control groups （ P 〈0. O1 ）. In multivariate analysis the factors associate with LN and SLEDAI were anti - C1q antibodies, anti - Sm antibodies. In patients with LN ,anti- C1q antibedies 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 of SLE .