狼疮性肾炎患者血清自身免疫抗体水平变化及相关性研究

Changes and correlation of serum autoimmune antibodies in patients with lupus nephritis

目的探讨狼疮性肾炎(LN)患者血清自身免疫抗体水平变化及其与系统性红斑狼疮(SLE)疾病活动性的相关性。方法选取2012年6月—2017年6月在沧州中西医结合医院风湿免疫科收治的狼疮性肾炎患者68例,并根据病情活动分为LN活动组(35例)和LN非活动组(33例),另纳入同期39例健康体检者为对照组。采用ELISA法测定各组受试者血清中抗ds-DNA、抗Sm抗体、抗r-RNP抗体及抗C1q抗体表达情况,各组间进行比较,并对各抗体表达与SLE疾病活动指数(SLEDAI)的相关性进行分析。结果 LN活动组抗ds-DNA抗体、抗Sm抗体、抗r-RNP抗体及抗C1q抗体阳性率分别为82.86%、34.29%、40.00%、57.14%,LN非活动组分别为69.70%、21.21%、24.24%、42.42%,对照组抗ds-DNA、抗C1q抗体阳性分别为5.13%、2.56%,无抗Sm抗体及抗r-RNP抗体阳性表达。3组比较各抗体阳性率均为LN活动组>LN非活动组>对照组,差异均有统计学意义(P<0.01)。经治疗6个月后,LN活动组和LN非活动组各抗体阳性率均下降,显著低于治疗前(P<0.01),而2组比较差异无统计学意义(P>0.05)。相关性分析结果表明,LN患者血清抗ds-DNA、抗C1q抗体、抗Sm抗体、抗r-RNP抗体及表达阳性率与SLEDAI评分均呈正相关(r=0.547、0.611、0.455、0.387,P均<0.05)。结论血清抗ds-DNA、抗Sm抗体、抗r-RNP抗体及抗C1q抗体表达情况能反映SLE疾病活动情况,并与LN肾损害程度相关。

To investigate the changes of serum autoimmune level in patients with lupus nephritis(LN)and its correlation with disease activity of systemic lupus erythematosus(SLE).Methods 68 patients with lupus nephritis were selected from June 2012 to June 2017 in the Department of Rheumatology and Immunology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine.They were divided into LN active group(35 cases)and LN inactive group(33 cases)according to their disease activity,and 39 healthy people were included in the control group during the same period.The expression of anti-ds-DNA,anti-Sm antibody,anti-r-RNP antibody and anti-C1q antibody in serum of all groups were determined by ELISA.The correlation between the expression of anti-ds-DNA,anti-Sm antibody,anti-r-RNP antibody and anti-C1q antibody and SLE disease activity index(SLEDAI)was analyzed.Results The positive rates of anti-ds-DNA,anti-Sm,anti-r-RNP and anti-C1q antibodies were 82.86%,34.29%,40.00%,57.14%in LN active group,69.70%,21.21%,24.24%,42.42%in LN inactive group,5.13%,2.56%in control group,and no anti-r-RNP and anti-Sm antibodies were expressed.The positive rate of each antibody was LN active group>LN inactive group>control group,the difference was statistically significant(P<0.01).After 6 months of treatment,the positive rate of LN active group and LN inactive group decreased,respectively,The positive rates of the two groups were lower than those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).The results of correlation analysis showed that the positive rates of anti-ds-DNA,anti-C1q,anti-Sm,anti-r-RNP antibodies in LN patients were positively correlated with SLEDAI scores(r=0.547,0.611,0.455,0.387,P<0.05).Conclusion The expression of anti-ds-DNA,anti-Sm antibody,anti-r-RNP antibody and anti-C1q antibody in serum can reflect the disease activity of SLE and is related to the degree of LN renal damage.