抗C1q抗体及补体C3、C4在神经精神性狼疮诊断中的应用价值

Value of anti-C1q antibody C3 and C4 in diagnosis of neuropsychiatric systemic lupus erythematosus

目的:探讨抗C1q抗体及补体C3、C4在神经精神性狼疮诊断中的应用价值。方法:对22例狼疮脑病及66例SLE患者进行横断面研究。抗C1q抗体采用ELISA方法,C3及C4采用免疫比浊法检测。分析补体与狼疮脑病的临床表现相关性,采用Logistic回归分析狼疮脑病的危险因素。结果:NPSLE患者抗C1q抗体水平明显高于非NPSLE患者,补体C4明显低于非NPSLE患者,采用ROC曲线分析抗C1q抗体诊断NPSLE敏感性及特异性分别为63. 6%、66. 7%。单因素分析后发现抗C1q抗体、抗核糖体P蛋白抗体、抗核小体抗体与神经精神性狼疮相关,但多因素Logistic回归分析并未发现其与狼疮脑病发生有关。补体C4降低与SLE患者脑血管意外发生有关。结论:抗C1q抗体在狼疮脑病诊断中具有一定的诊断价值,且补体C4可能参与狼疮脑病脑血管意外的发生。

Objective： To evaluate the application of anti-C1q antibody and C3 and C4 in the diagnosis of neuropsychiatric systemic lupus erythematosus（NPSLE）. Methods： We conducted a cross-sectional study of 22 patients with NPSLE and 66 patients SLE. Anti-C1q antibody was assayed by ELISA,C3 and C4 was assayed by Immunoturbidimetry. The correlation between the clinical manifestations and complement was analyzed. Logistic regression analysis was performed to find the association of anti-C1q antibodies with NPSLE. Results： The anti C1q antibody level of NPSLE was significantly higher than non-NPSLE patients,complement C4 significantly lower than non-NPSLE,using ROC curve analysis of anti-C1q antibody sensitivity and specificity in the diagnosis of NPSLE patients were 63. 6%,66. 7%,after using single factor analysis found that resistance against C1q antibody,anti-ribosomal P protein antibodies and anti-nucleosome antibodies were the predictive factors of NPSLE,but the multi-factor Logistic regression analysis was no associated with lupus encephalopathy. But complement C4 reduce had associated with SLE patients with cerebrovascular accident. Conclusion： The anti-C1q antibody has certain diagnostic value in the diagnosis of NPSLE,complement C4 may participate the occurrence of cerebrovascular accident of NPSLE.