可溶性E-钙粘蛋白(SE-CAD)在系统性红斑狼疮中的临床研究

Clinical Study of soluble E-cadherin in systemic lupus erythematosus

目的探讨血清可溶性E-钙粘蛋白(soluble E-cadherin,SE-CAD)在系统性红斑狼疮(SLE)中的表达,并分析其与SLE患者一些临床指标的相关性。方法 95例SLE患者(均为女性)作为实验组,35名健康体检女性作为对照组,检测血清SE-CAD、ESR、甘油三酯等的水平。结果 SLE患者血清SE-CAD水平高于健康对照组,将SE-CAD作为因变量,患者年龄、ESR、血肌酐、GFR、胆固醇、甘油三酯、白细胞介素6(IL-6)和基质金属蛋白酶-3(MMP-3)作为自变量,多元回归分析,SLE患者血清SE-CAD水平与年龄、ESR、血肌酐、胆固醇、甘油三酯、IL-6和MMP-3呈正相关,其中血肌酐、年龄、ESR和甘油三酯为主要影响因素。在血肌酐﹥90μmol/L、GFR<50ml/min或者合并肾炎的SLE患者中血清SE-CAD水平显著升高。结论血清SE-CAD水平可以反映SLE患者的活动性。而且在SLE患者合并肾炎时显著升高,提示血清SE-CAD水平可以作为诊断狼疮性肾炎的一个标志物。

Objective To measure serum levels of SE-CAD in systemic lupus erythematosus（SLE）and to determine associations between serum levels of SE-CAD and markers of inflammation and organ damage in female patients with SLE.Methods Serum levels of SE-CAD were analyzed by ELISA in 95 female patients with SLE and 35 healthy women.Multiple regression analyses between SE-CAD levels and disease-related variables were performed in patients with SLE.Results Serum levels of SE-CAD were elevated in patients with SLE compared with levels in healthy controls.SE-CAD levels correlated positively with age、disease duration、erythrocyte sedimentation rate（ESR）,s-creatinine,cholesterol,triglycerides,interleukin 6,and matrix metalloproteinase-3.In multiple regression analysis,s-creatinine、age、ESR and triglycerides remained determinants of SE-CAD.Within the patients with SLE,higher SE-CAD levels were found only in patients with renal damage（s-creatinine 90μmol/l,glomerular filtration rate 50ml/min,or renal involvement ever by SLE）.Conclusion We hypothesized that serum levels of SE-CAD reflect the disease activity of SLE.In the patients with SLE whose kidneys are affected,the SE-CAD levels were also significantly increased compared with other patients with SLE and healthy controls.Therefore SE-CAD may be used as a biomarker for kidney damage in patients with SLE.