系统性红斑狼疮患者狼疮性肾炎诊断的多指标临床评价

Clinical evaluation of multiple index for diagnosis of lupus nephritis in the patients with systemic lupus erythematosis

目的探讨血清尿素、血清肌酐、血清胱抑素C、尿微量白蛋白、尿转铁蛋白、尿α1-微球蛋白、尿N-乙酰-β-D葡萄糖苷酶和尿足细胞标志蛋白,在系统性红斑狼疮(SLE)患者狼疮性肾炎(LN)诊断中的临床价值。方法对SLE合并LN患者41例、SLE未合并LN患者15例和50例健康对照组血清进行Urea、Cr和Cys C水平测定,同时对尿液中MA、TRU、α1-MG、NAG和PCX水平进行测定。结果 SLE合并LN患者血清urea、Cr和Cys C水平及尿液PCX、TRU、MA、NAG、α1-MG水平都显著高于SLE未合并LN患者和对照组(均P<0.05)。结论血cys C、尿TRU和尿α1-MG联合检测既可同时监测LN患者的肾小球滤过功能损害、肾小球滤过膜损害和近端肾小管损害,又可提高灵敏度,是SLE患者早期肾损害的敏感、方便、有效的指标。

Objective To explore clinical value of serum urea, serum creatinine（ Cr）, serum cystatin C（ Cys C）, urine microalbumin（MA）, transferrinuria（TRU）, urine a,-microglobulin（α1-MG）, urine N-acetyl-β-glucosaminidase（NAG） and urine podocalyxin （PCX） for diagnosis of lupus nephritis（ LN） in the patients with systemic lupus erythematosis（ SLE）. Methods The levels of urea, Cr and Cys C were measured in the sera from 41 SLE patients with LN, 15 SLE patients without LN and 50 healthy control group, meanwhile, the levels of MA, TRU ,α1 -MG, NAG and PCX in urine from them were measured. Results The levels of urea, Cr, Cys C, MA, TRU, α1-MG, NAG and PCX were higher in SLE patients with LN than these in SLE patients without LN and healthy control group （ P 〈 0. 05）. Conclusion They were the sensitive, simple, and effective indexes for the diagnosis of early renal injury in the patients with SLE.