系统性红斑狼疮肾损伤患者血清CRP、血尿酸和免疫球蛋白水平的变化及意义

Changes of serum CRP,serum uric acid and immunoglobulin in patients with renal damage of systemic lupus erythematosus

目的:观察系统性红斑狼疮(systemic lupus erythematosus,SLE)肾损伤患者血清C反应蛋白(CRP)、血尿酸和免疫球蛋白(IgG、IgA和IgM)的表达水平,探讨其在SLE肾损伤患者中的临床应用价值。方法:将收治的95例SLE患者按照狼疮肾炎(lupus nephritis,LN)诊断标准分为狼疮肾炎组(LN组,n=64)和非狼疮肾炎组(NLN组,n=31),另选取35例健康体检者为正常对照组。治疗前采集所有受试者血液样本,用ELISA法检测血清CRP和血尿酸浓度,并同步用免疫透射比浊法检测血清免疫球蛋白的水平,分析检测结果。结果:SLE组患者血清CRP和血尿酸水平均显著高于正常对照组(P<0.05);其中,SLE患者LN组血清CRP和血尿酸水平均显著高于NLN组和正常对照组(P<0.05);SLE患者NLN组血清CRP水平显著高于正常对照组(P<0.05);NLN组血尿酸水平略高于正常对照组,但比较差异无统计学意义(P>0.05)。SLE组患者血清免疫球蛋白水平高于正常对照组(P<0.05);其中,SLE患者LN组血清免疫球蛋白IgG、IgA和IgM水平均显著高于NLN组和正常对照组(P<0.05);SLE患者NLN组血清免疫球蛋白IgG、IgA和IgM水平均高于正常对照组,比较差异有统计学意义(P<0.05)。结论:SLE肾损伤患者体液免疫被不同程度地激活,B细胞功能亢进,全身炎症反应严重,肾脏存在不同程度受损;血清CRP、血尿酸和免疫球蛋白(IgG、IgA和IgM)可能参与了SLE肾损伤病理过程,是早期诊断的参考指标。

Objective：To observe the expression of serum CRP,serum uric acid and immunoglobulin（IgG,IgA and IgM）in patients with renal damage of systemic lupus erythematosus,and to explore their clinical application value.Methods：A total of 95 patients with SLE were divided into lupus nephritis group（LN group,n=64）and non-lupus nephritis group（NLN group,n=31）according to the diagnostic criteria of lupus nephritis.Besides,35 healthy subjects were selected as normal control group.Blood samples were collected from all subjects before treatment.Serum CRP and serum uric acid concentrations were measured by ELISA.The levels of serum immunoglobulins were detected by immunoturbidimetry.Finally,the results were analyzed statistically.Results：The levels of serum CRP and serum uric acid in patients with SLE were significantly higher than those in NLN group and normal control group（P0.05）.The levels of serum CRP and serum uric acid in LN group of SLE patients were significantly higher than those in NLN group and normal control group（P0.05）.The serum CRP level in NLN group was significantly higher than that in normal control group（P0.05）.The serum uric acid level of NLN group was slightly higher than that of the control group,but the difference was not statistically significant（P0.05）.The level of serum immunoglobulin in SLE group was higher than that in normal control group（P0.05）.The levels of serum immunoglobulin IgG,IgA and IgM in LN group of SLE patients were significantly higher than those in NLN group and normal control group（P0.05）.The levels of serum immunoglobulin IgG,IgA and IgM in NLN group of SLE patients were significantly higher than those in normal control group（P0.05）.Conclusions：The humoral immunity of patients with SLE renal injury was activated,with B-cell hyperthyroidism,severe systemic inflammatory response and kidney damage to varying degrees.Serum CRP,serum uric acid and immunoglobulin（IgG,IgA and IgM）may be involved in SLE renal injury pathological process,and they are the reference indicators for the early diagnosis of systemic lupus erythematosus.