补体C1q在自身免疫性肾病及不同阶段慢性肾脏病中的临床意义探究

The research on the clinical significance of serum level of C1q in autoimmune nephrosis and different stages of chronic kidney disease

目的评价血清中补体C1q在自身免疫性肾病诊断中的意义,探究慢性肾脏病（CKD）不同阶段的患者血清中的C1q水平的变化。方法收集肾病内科收治的自身免疫性肾病的患者27例,CKD2期患者30例,CKD3期患者37例,CKD4期患者38例,CKD5期患者91例,健康人40例为对照组。采用免疫透射比浊法进行血清C1q及肾功能指标检测。结果自身免疫性肾病患者血清中C1q水平明显低于对照组,同时肌酐（Cr）和尿素氮（Bun）水平显著升高,二氧化碳（CO_2）水平显著降低,差异具有统计学意义（P〈0.05）;CKD2~5期患者血清中C1q水平明显低于对照组,差异有统计学意义（P〈0.05）;Bun和Cr水平在CKD2~5期患者中均高于对照组,差异有统计学意义（P〈0.05）,且CKD分期越晚,两种指标的水平越高,差异有统计学意义（P〈0.05）。β2-微球蛋白（β2-MG）水平在CKD3、4、5期患者中均高于对照组与CKD2期患者,差异有统计学意义（P〈0.05）。与对照组相比,CKD2、3、4、5期患者血清CO_2水平明显降低而尿酸（UA）水平明显升高,差异有统计学意义（P〈0.05）。不同CKD分期的血清内C1q水平无明显变化。结论血清C1q水平在自身免疫性肾病中有着重要的临床意义,可作为自身免疫性肾病的辅助诊断的重要指标。

Objective To evaluate the significance of complement component C1q in the diagnosis of autoimmune nephrosis and to investigate the changes of complement component C1q of patients with chronic kidney disease（CKD）.Methods Twenty-seven patients with autoimmune nephrosis,30 patients with CKD2,37 patients with CKD3,38 patients with CKD4,91 patients with CKD5 in nephrology department and 40 healthy controls were collected.The serum leve1 of C1q was detected by immunity transmission turbidity.Results The content of the serum C1q in patients with autoimmune nephrosis group was significantly lower than that of the control group（P〈0.05）.And the levels of creatinine（Cr）and urea nitrogen（Bun）in autoimmune nephrosis group were significantly higher than that of control group,while the level of carbon dioxide（CO_2）in autoimmune nephrosis group was significantly lower than that of control group（P〈0.05）.The levels of C1q of patients in CKD2,3,4and 5were significantly lower than that of control group（P〈0.05）.And the levels of Bun and Cr of patients in CKD2,3,4,and 5were significantly higher than that of the control group（P〈0.05）.Meanwhile,the later the stage of CKD,the higher the levels of Bun and Cr.The level of β2-microglobulin of patients in CKD3,4and 5was significantly higher than that of patients in CKD2（P〈0.05）.In addition,the levels of CO_2 of patients in CKD2,3,4and 5was significantly lower while uric acid（UA）was significantly higher than control group（P〈0.05）.The level of the serum C1q didn′t change significantly in different stages of CKD.Conclusion The serum C1q is one of important parameters for the diagnosis of autoimmune nephrosis.