系统性红斑狼疮患者血循环免疫复合物和补体水平变化及其临床意义

Significance of circulating immune complexes and complement in the patients with systemic lupus erythematosus

目的探讨定量检测血循环免疫复合物(circulating immune complexes,CIC)以及补体C3、C4在系统性红斑狼疮(systemic lupus erythematosus,SLE)诊断及评价活动性中的意义。方法用ELISA法定量检测SLE患者和其他风湿病患者血清中的CIC,散射比浊法检测补体C3、C4。据SLEDAI积分表,将SLE患者分为Ⅰ组(SLEDAI评分0～4分)、Ⅱ组(SLEDAI评分5～9分)和Ⅲ组(SLEDAI评分≥10分)。结果SLE患者CIC明显高于疾病对照组(P值<0.05),补体C3、C4明显低于疾病对照组(P值<0.05);CIC和补体C3:Ⅱ组、Ⅲ组与Ⅰ组比较差异有显著性(P值<0.05),而补体C4仅Ⅲ组与Ⅰ组比较差异有显著性(P值<0.05)。相关分析显示CIC与SLEDAI积分呈正相关,补体C3、C4与SLEDAI积分呈负相关。结论血清CIC和补体C3、C4可作为SLE诊断及评价活动性的有用指标,动态观测CIC和补体C3来评价SLE活动性优于补体C4。

Objective To evaluate the significance of circulating immune complexes（CIC）, complement C3 and C4 on the diagnosis and the disease flare in patients with systemic lupus erythematosus （SLE）. Methods ELISA was used to determine serum CIC in the patients with SLE and other autoimmune disease.C3 and C4 in serum was assayed by Rate Nephelometry.The SLE patients was dilivded into three groups according to the SLEDAI score：SLEDAI 0 - 4 group（group A）, SLEDAI 5 - 10 group（group B） and SLEDAI ≥ 10 group（group C）. Results The levels of CIC in the patients with SLE were significantly higher than the patients with other autoimmune disease（P〈0.05）.The levels of C3 and C4 in the patients with SLE were significantly lower than the patients with other autoimmune disease（P〈0.05）. Compared with group A, the levels of CIC and C3 in group B and group C had significant difference（P〈0.05）, and the levels of C4 only in group C had significant difference（P〈0.05）.There was a significant correlation between the levels of CIC in the patients with SLE and SLEDAI score （ r=0.496, P〈0.001 ）.Conclusions The levels of CIC, C3 and C4 in serum can be used as indexes which were easy to be observed on the diagnosis in patients with SLE, and as indexes to study the disease flare in patients with SLE, the levels of CIC and C3 may be better than C4.