狼疮肾炎患者血清晚期蛋白氧化产物水平与疾病活动的相关性

The correlation between advanced oxidation protein products( AOPP) and theactivity of lupus nephritis

目的探讨氧化应激标志物晚期蛋白氧化产物(AOPP)在狼疮肾炎(LN)患者血清水平变化及其与LN疾病活动的相关性。方法 LN患者29例,根据肾小球滤过率(eGFR)水平分为eGFR≥60 m L/(min·1.73m2)组16例、eGFR<60 m L/(min·1.73 m2)组13例。同期选择性别、年龄、体重匹配的健康对照者21例(对照组),测定各组血肌酐(Scr)、尿素氮(BUN)、血白蛋白(ALB)、血沉(ESR)、C反应蛋白(CRP)、补体C3、C4以及24h尿蛋白定量(24h UPQ)、eGFR;ELISA法测定各组患者的AOPP、丙二醛(MDA)、抗ds DNA抗体;运用系统性红斑狼疮(SLE)疾病活动指数(SLEDAI)积分表对LN患者的疾病活动性进行评分。结果 LN组患者CRP、ESR、24h UPQ、抗ds DNA抗体、AOPP、MDA均较对照组明显升高,差异有统计学意义(P<0.05),C3、C4、eGFR较对照组降低,差异有统计学意义(P<0.05);LN患者eGFR<60组ESR、MDA较eGFR≥60组明显升高,差异有统计学意义(P<0.05);而CRP、AOPP、抗ds DNA抗体、SLEDAI积分、24h UPQ均较eGFR≥60组升高,但差异无统计学意义(P>0.05);血清AOPP与MDA呈显著正相关(r=0.942,P<0.05),与抗ds DNA抗体呈显著正相关(r=0.982,P<0.05),与SLEDAI积分呈正相关(r=0.653,P<0.05),与eGFR呈负相关(r=-0.298,P<0.05)。结论 LN患者血清AOPP水平明显升高,且随着肾功能损害而进一步升高,可作为一种评估LN氧化应激状态的指标。AOPP与LN疾病活动性密切相关。

Objective To investigated the serum AOPP levels,and the correlation between AOPP and the activity of lupus nephritis( LN). Methods Twenty- nine LN patients were included in LN group,and 21 age,weight and gender- matched controls were also included. The 29 LN patients were further divided into eGFR≥60 group and eGFR < 60 group according to eGFR. The Scr,BUN,ALB,ESR,CRP,C3,C4,24 h UPQ and eGFR were evaluated in all subjects.The levels of AOPP,MDA,and anti- ds DNA were detected with ELISA. LN activity wasevaluated according to SLE disease activity index. Results The LN group exhibited significantly higher CRP,ESR,24 h UPQ,anti- ds DNA,AOPP,and MDA levels,but lower C3,C4,and eGFRcompared to those in controls( P < 0. 05). In eGFR < 60 subgroup,significantly higher ESR,MDA was revealed whencompared to those in eGFR≥60 subgroup( P < 0. 05). Serum AOPP was significantly positively correlated with MDA( r = 0. 942,P < 0. 05),anti- ds DNA( r = 0. 982,P < 0. 05),and SLEDAI scores( r = 0. 653,P < 0. 05); but negatively correlated with eGFR( r =- 0. 298,P < 0. 05). Conclusion The serum AOPP levels are evaluated in LN patients. And AOPP increases with the progression of renal dysfunction. AOPP is a biological marker that reflects oxidative stress in LN patients. Higher serum AOPPis correlated with LN disease activity.