系统性血管炎常用指标对疾病活动评估的意义

Routine parameters in the disease activity assessment of systemic vasculitis

目的寻找对系统性血管炎(SV)患者疾病活动度有评估意义的指标。方法回顾分析SV患者24例(病例组)及对照组20例的相关指标,对比分析两组免疫球蛋白(IgA、IgG、IgM)、C反应蛋白(CRP)、红细胞沉降率(ESR)、补体(C3、C4)的特点,计算两组血清免疫球蛋白与CRP、ESR、补体之间的相关系数,并应用Logistic回归分析计算上述指标与SV疾病活动度的相关性。结果病例组三种免疫球蛋白较对照组升高,IgA差异有统计学意义(P<0.05),IgG、IgM差异无统计学意义;病例组CRP、ESR均值高于对照组,差异有统计学意义(P<0.01);两组间C3、C4差异无统计学意义。病例组IgA与ESR呈正相关,IgM与C4呈负相关,CRP与ESR呈显著正相关;对照组仅IgG与CRP呈正相关。Logistic回归分析提示ESR与疾病活动有显著相关性。结论 CRP、ESR是系统性血管炎疾病活动的良好指标,免疫球蛋白升高对疾病活动有一定的提示意义,可以作为补充。

Objective To explore items associated with systemic vasculitis disease activity.Methods The retrospective analysis were performed from 24 patients with active systemic vasculitis and 20 age-matched cases.The age,sex,serum levels of IgA,IgG,IgM,CRP,ESR,C3 and C4 were analyzed.The correlation coefficient between im-munoglobulin and CRP,ESR,complement was calculated by Pearson test.The Logistic regression between the parame-ters and disease activity status were analyzed.Results The concentrations of serum IgA,IgG,IgM were higher in ac-tive systemic vasvulitis patients than those in the control,and there was significant difference in the level of IgA be-tween the two groups.The levels of CRP and ESR were significantly higher in the patients with systemic vasculitis. There were no significant differences in the level of C3 and C4 between the two groups.The positive correlation was found in the level of IgA and ESR,CRP and ESR while IgMwas negatively correlated with C4,in SV group.In control group,IgG was correlated with CRP.Logistic regression analysis showed that ESR was significantly correlated with dis-ease activity.Conclusion CRP and ESR are indicators for the disease activity of systemic vasculitis,and the level of IgA,IgG,IgM have certain reference value.