系统性红斑狼疮活动性与感染指标临床应用价值探讨

Research on the clinical application value of infection index and activity index in patients with systemic lupus erythematosus

目的分析系统性红斑狼疮(SLE)病情活动和合并感染患者临床特点和血清学指标,发现对疾病活动和感染有鉴别意义的指标。方法对189例SLE患者进行研究,按SLEDAI积分分为活动组与稳定组;按是否合并感染分为感染组与未感染组。分析患者C反应蛋白(CRP)、红细胞沉降率(ESR)、免疫球蛋白(Ig)、补体、血常规、清蛋白、球蛋白、尿素氮、肌酐、24h尿蛋白(24hUP)及抗核抗体谱的变化。结果活动组ESR、IgG、IgA、24hUP、球蛋白高于稳定组,抗ds-DNA抗体和抗核小体抗体阳性率高于稳定组,C3、C4和清蛋白低于稳定组。感染组ESR、CRP高于未感染组。结论 ESR、IgG、IgA、C3、C4、24hUP、清蛋白、球蛋白、抗ds-DNA抗体和抗核小体抗体可用于SLE活动性判断,CRP可作SLE合并感染可靠的指标。

Objective To discover the index that can differentiate infection and activity of systemic lupus erythematosus（SLE）.Methods 189 patients with SLE were divided into active group and steady group according to SLEDAI,and infectious group and taintless group according to infection status.C reactive protein（CRP）,erythrocyte sedimentation rate（ESR）,immunoglobulin（Ig）,complement,blood routine examination,albumin,globulin,urea nitrogen,creatinine,24 h urine protein（24hUP） and antinuclear antibodies repertoire were investigated.Results ESR,IgG,IgA,globulin,24hUP,positive rate of ds-DNA antibody and anti-nucleosome antibody were higher in active group than those in steady group,and C3,C4 and albumin were significantly lower in active group than those in steady group.ESR and CRP were significantly higher in infectious group than those in taintless group.Conclusion ESR,IgG,IgA,C3,C4,albumin,globulin,24 hUP,ds-DNA antibody and anti-nucleosome antibody might be useful for monitoring the disease activity of SLE,and CRP could be a good marker to distinguish infection complications in patients with SLE.