狼疮性肾炎患者血清抗C1q自身抗体在肾损评判中的应用

Clinical application of the level of anti-C1q autoantibody in lupus nephritis

目的探讨血清中抗C1q自身抗体水平在系统性红斑狼疮性肾炎(LN)组与非系统性红斑狼疮性(SLE)肾炎组之间的关系;解析抗C1q自身抗体对LN的诊疗价值。方法研究对象:来自该院就诊的LN患者82例,无合并狼疮指针的肾炎患者38例,门诊正常体检者35例。试验方法:抗C1q自身抗体采用ELISA法检测;24h尿蛋白、血清肌酐(Cr)采用全自动生化分析仪定量检测。方差分析比较各组抗C1q自身抗体、24h尿蛋白和Cr含量等指标的均值差异,χ2分析组间阳性率或异常百分比。结果与正常对照组相比,各指标在肾炎2组中均有较高的阳性率;肾炎2组间,仅抗C1q抗体单指标LN组阳性率高于非SLE肾炎组(P<0.01),而24h尿蛋白水平与Cr水平在肾炎2组间的差异均无统计学意义(P值均大于0.05)。结论抗C1q自身抗体与SLE合并肾损密切相关,抗C1q抗体水平可为临床判断SLE患者有无肾损及病程估算提供良好依据。

Objective To investigate the correlation between the level of anti- Clq autoantibody in serum and the nephritis of systemic lupus erythematousus,and to study the diagnostic and therapeutic value of anti- Clq autoantibody to lupus nephritis. Methods The methods of enzyme linked immunosorbent assay,nephelometry and automatic biochemistry analyzer were applied respec- tively to analyze the level of anti- Clq autoantibody, 24 h Urine protein and creatinine in lupus nephritis group（82 cases）, nonlupus nephritis group（38 cases） and normal group（35 cases）. Results The level of anti- Clq autoantibody in serum increased significantly in lupus nephritis patients as compared with that in nonlupus nephritis patients（P〈0. 01 ,P〈0.05） and normals（P〈0.01 ,P〈0. 01）. The level of 24 h Urine protein and creatinine in serum increased significantly in lupus nephritis patients and nonlupus nephritis patients as compared with that in normals（P〈0.01）, but no difference was found between the two nephritis groups（P〉0. 05）. The positive rate of anti- Clq autoantibody increased significantly in lupus nephritis patients as compared with that in nonlupus nephritis patients（P〈0.01, P〈0. 05） ,but no difference was found between the two nephritis groups in the positive rate of 24 h Urine protein and creatinine（P〉0.05,P〉0.05）. Conclusion Anti- Clq autoantibody may be associated with the nephritis of systemic lupus erythematousus. The level of anti- Clq autoantibody may be applied to judge the damage of kidney and to estimate the course of disease for clinic.