系统性红斑狼疮患者补体C3变化及临床意义探讨

Clinical and serological value of complement C3：a retrospective study of 1405 hospitalized patients with systemic lupus erythematosus

目的对系统性红斑狼疮（SLE）患者补体进行测定并进行临床意义探讨。方法由各参研单位根据统一方式收集病历资料，总结江苏省1999-2009年间住院1405例SLE患者的临床资料，分析补体与SLE临床表现、免疫学指标、疾病活动间的关系。统计学处理组间的计数资料比较采用，检验，非正态分布的定量资料比较采用秩和检验，相关性研究采用LogisticRegression分析。结果1405例SLE患者纳入研究范围，其中补体c3降低组1042例，补体c3正常组363例，通过对照研究，补体c3降低组入院年龄、病程、住院次数、浆膜炎、胃肠道累及、肝脾淋巴结肿大、白细胞、血红蛋白、血小板、C反应蛋白（CRP）、白蛋白、血清肌酐、尿蛋白、抗核抗体、抗双链DNA（dsDNA）抗体、抗Sm抗体、SLE疾病活动指数（SLEDAI）积分与正常组比较差异有统计学意义（P〈0．05）；LogisticRegreSSion分析显示CRP（OR：0．396，0．254-0．617，P=0．000）、抗核抗体（OR：2．907，1．267．6．670，P=-0．012）、尿蛋白（OR：1．702，1．043-2．779，P=0．033）及入院SLEDAI评分（OR=0．930，0．886-0．975，P=0．003）是与补体c3降低有显著相关的因素。结论补体c3作为SEE常用的临床检测指标，与SEE病情活动密切相关，也是肾累及的危险因素。

Objective To investigate the association of complement C3 with clinical and serological features of patients with systemic lupus erythematosus. Methods Data was collected by the same methods in the past ten years in fifteen hospitals in Jiangsu Province and then data weres summarized for retrospective analysis. Clinical and laboratory data were selected and then analyzed by Chi-square test, Wilcoxon rank sum test and Logistic regression. Results One thousand four hundred and five patients were investigated. One thousand and forty two had low serum complement C3 level, in this case control study, hospitalization age, disease course, admission times, pleurisy, gastrointestinal involvement, general lymphadenopathy/hepatos- plenomegaly, white blood cell count, haemoglobin level, platelet count, serum C-reactive protein level, serum albumin level, serum creatinine level, Urine protein quantification, anti-nuclear antibodies（ANA）, anti-dsDNA antibodies, anti-Sin antibodies and SLEDAI score were possible factors associated with complement C3 reduction（P〈0.05）. Logistic regression analysis showed that CRP （0R=0.396, 0.254-0.617, P=0.000）, ANA （0R=2.907, 1.267-6.670, P=0.012）, urine protein level （0R=1.702, 1.043-2.779, P=0.033） and SLEDAI score （OR =0.930, 0.886-0.975, P=0.003） were correlated with complement C3 reduction. Coneluslon Complement C3 level is valuable for lupus flare assessment. The complement C3 reduction is a risk factor for renal impairment.