循环内皮细胞在狼疮性肾炎血管病变诊断中的应用

Evaluation of renal vascular lesions using circulating endothelial cells in patients with lupus nephritis

目的:检测狼疮性肾炎(LN)患者循环血内皮细胞(CECs),探讨其在肾脏血管病变的诊断和判断病情中的作用。方法:60例经肾活检诊断为LN患者,其中30例伴血管病变患者,30例不伴血管病变患者。正常对照为30名健康志愿者。抽取外周血,采用免疫磁珠分离方法计数CECs的数量,同时进行血清肌酐、尿蛋白和尿红细胞等临床项目检查。结果:不伴血管病变组LN患者CECs数目与正常对照组相比差异无统计学意义,伴血管病变组患者CECs数目显著高于不伴血管病变组和正常对照组(P<0.01)。伴血管病变组患者CECs与血清肌酐水平呈正相关(r=0.513,P<0.01)。在伴血管病变LN患者中,合并血栓性微血管病变(TMA)患者CECs数量明显高于不伴有TMA患者(P<0.01)。结论:CECs检测不仅能反映LN患者血管病变的存在,而且还能作为判断血管病变严重程度的指标。

Objective ：The aim of the present study is to investgate the correlation between circulating endothelial cells （CECs） and renal vascular lesions. Methodology： Sixty LN patients were recruited in this study. According to with or without renal vascular lesions they were divided into two groups （there were thirty cases in each group）. Another thirty age-and sex-matched healthy volunteers served as controls. CECs were isolated from peripheral blood with anti-CD-146-coated immunomagnetic Dynabeads and were counted by microscopy. Results：The number of CECs was significantly higher than those patients without vascular lesion （ P 〈 0. 01 ）, while there were no difference between LN patients without vascular lesion and control group. A strong positive correlation was found between CECs and renal function （serum creatinine） （r = 0. 513, P 〈0. 01）. In all of LN patients with vascular lesion, the nember of CECs in patients with TMA was significantly increase compared with those without TMA （ P 〈 0. 01 ）. Conclusion ： Circulating endothelial cells are a novel biomarker of vascular injury of renal diseases. Dynamic observation of the numbers of CECs can provide evidence to diagnose the vascular lesions, know the change of the diseases and observe effect of the therapy.