狼疮肾炎患者血清、尿液颗粒蛋白水平及其评估疾病活动性的价值

Levels of granulin in serum and urine of patients with lupus nephritis and its assessment value for disease activity

目的探讨狼疮肾炎(LN)患者血清、尿液颗粒蛋白(GRN)水平及其评估LN活动性的价值。方法选取119例肾炎患者和65名健康志愿者(健康对照组),将肾炎患者分为LN组65例和非LN组54例,并根据治疗后病情将LN患者分为稳定组21例和活动组44例。比较LN组、非LN组、健康对照组的血清与尿液GRN水平,比较稳定组和活动组的血补体C3、抗双链DNA(dsDNA)抗体水平及血、尿GRN水平,采用受试者工作特征(ROC)曲线评估尿GRN水平及血清C3、抗dsDNA抗体水平对LN活动性的评估价值。结果 LN组、非LN组、健康对照组血、尿GRN水平均依次降低(P<0.05)。治疗后,稳定组C3水平高于活动组,抗dsDNA抗体和尿液GRN水平均低于活动组(P<0.05)。ROC分析结果显示,尿GRN水平、血清抗dsDNA抗体及C3水平评估LN疾病活动性的曲线下面积分别为0.725、0.709、0.753。结论尿液GRN或可作为LN的特异性生物标记,其水平对LN活动情况有一定的评估价值。

Objective To investigate levels of granulin(GRN)in serum and urine of patients with lupus nephritis(LN)and its assessment value for disease activity of LN.Methods A total of 119 patients with nephritis and 65 healthy volunteers(healthy control group)were selected,and patients with nephritis were divided into LN group(65 cases)and non-LN group(54 cases).The LN patients were divided into stable group(21 cases)and active group(44 cases)according to the disease severity after treatment.The levels of serum and urine GRN were compared among the LN group,the non-LN group and the healthy control group,and the levels of serum C3 and double-stranded DNA(dsDNA)antibody as well as the levels of serum and urine GRN were compared between the stable group and the active group.Receiver operating characteristic(ROC)curve was used to evaluate the assessment value of urine GRN,serum C3 and dsDNA antibody levels for disease activity of LN.Results The levels of serum and urine GRN decreased in the sequence of the LN group,the non-LN group and the healthy control group(P<0.05).After treatment,the stable group obtained a higher level of C3,a lower level of dsDNA antibody and a lower level of urine GRN compared to the active group(P<0.05).The result of ROC analysis showed that the areas under curve for the level of urine GRN,the serum dsDNA antibody level and the serum C3 level in the assessment of disease activity of LN were 0.725,0.709 and 0.753,respectively.Conclusion Urine GRN may be a specific biomarker for LN,and its level has a certain assessment value for LN activity.