SLE患者血清抗C1q抗体浓度与其活动性及肾损伤实验指标的关系

Relationship between Anti-C1q Antibody Concentration,Disease Activity and Nephric Impairment in Systemic Iupus Erythematosus

目的探讨系统性红斑狼疮(SLE)患者血清中抗C1q抗体水平与其肾损的关系。方法将118例SLE患者分为SLE活动组81例和SLE稳定组37例;非SLE的其他自身免疫性疾病56例,正常对照组35例。抗C1q抗体采用ELISA法检测,抗ds-DNA抗体测定采用化学发光法,β2-微球蛋白(β2-MG)测定采用速率法测定,24h尿蛋白定量检测采用邻苯三酚红法。比较各组抗C1q抗体、抗ds-DNA抗体、β2-MG和24h尿蛋白定量等指标的均值差异和阳性率或异常百分比,并分析118例SLE患者血清中抗C1q抗体浓度与SLE疾病活动指数(SLEDAI)、抗ds-DNA抗体、β2-MG和24h尿蛋白定量的相关性。结果抗C1q抗体浓度在SLE活动组为54.12±47.64RU/ml,明显高于SLE稳定组9.87±19.36RU/ml,非SLE的其他自身免疫性疾病组(16.24±14.06RU/ml)和正常对照组(0.84±1.28RU/ml)(均P<0.01)。抗C1q抗体在SLE活动组、SLE稳定组、非SLE的其他自身免疫性疾病组和正常对照组的阳性率分别为80.2,10.8,30.4和0.0。SLE活动组的抗ds-DNA抗体浓度也明显高于SLE稳定组、非SLE自身免疫性疾病组和正常对照组(P<0.01)。SLE活动组的β2-MG和24h尿蛋白定量水平均高于SLE稳定组(P<0.05)。以抗C1q抗体为变量,以SLEDAI、抗ds-DNA抗体、β2-MG和24h尿蛋白定量为因变量,分别进行相关分析,SLE病人血清中的抗C1q抗体与SLEDAI(r=0.483,P<0.01)、抗ds-DNA抗体(r=0.372,P<0.01)和β2-MG(r=0.277,P<0.01)呈正相关,而与24h尿蛋白定量无相关性。结论抗C1q抗体水平是判断SLE疾病活动性的重要指标,其浓度变化可作为临床判断SLE患者有无肾早期损伤的敏感指标。

Objective To explore the relationship between anti-Clq antibody concentration and nephric impairment in systemic lupus erythematosus （SLE）. Methods 118 case SLE patients were divided into the active group and the stable group, 56 patients suffered from other autoimmune disease and 35 healthy blood donors. Anti-Clq antibody was measured by enzyme-linked immunosorbent assay（ELISA） in all groups. Then analyzed the correlations between anti-Clq anti-body and other parameters in 4 groups. Results Anti-Clq antibody in 4 groups were ：54.12±47.64,9.87±19. 36,16.24±14. 06 and 0.84±1.28 RU/ml. The positive rate in 4 groups were：80.2%,10.8%,30.4% and 0.0%. Anti-Clq antibody was positively correlated with the SLEDAI,anti-ds-DNA antibody and β2-MG,but in correlated with 24h urinary albumin in patients SLE. Conclusion It is suggested that anti-Clq antibody is positively correlated with disease activity and early renal injury in patients with SLE.