狼疮性肾炎患者血清S100A8/A9水平变化及临床意义

Levels and clinical significance of S100A8/A9 in serum of patients with lupus nephritis

目的探讨狼疮性肾炎(LN)患者血清中S100A8/A9的水平变化及与临床指标的相关性。方法选取LN患者58例作为LN实验组,根据系统性红斑狼疮疾病活动指数(SLEDAI)评分将其分为LN活动期组38例(总分≥10分)、LN稳定期组20例(总分<10分),选择与LN患者性别、年龄以及体重指数(BMI)均相匹配的健康体检者30例作为健康对照组。采用酶联免疫吸附法(ELISA)检测血清S100A8/A9的表达水平,同时搜集整理LN患者临床资料。结果①LN实验组血清S100A8/A9水平高于健康对照组,差异有统计学意义(P<0.01);②LN活动组血清S100A8/A9水平高于LN稳定期组和健康对照组,差异有统计学意义(P<0.01);LN稳定期组血清S100A8/A9水平高于健康对照组,差异无统计学意义(P>0.05);③LN患者血清S100A8/A9水平与抗双链DNA抗体(anti-dsDNA)、C反应蛋白(CRP)、血肌酐(Scr)、24h尿蛋白、SLEDAI评分呈正相关(r=0.270,P=0.040;r=0.400,P=0.002;r=0.380,P=0.003;r=0.300,P=0.020;r=0.900,P=0.000);与补体C3、补体C4、内生肌酐清除率(Ccr)呈负相关(r=-0.280,P=0.036;r=-0.380,P=0.0360;r=-0.322,P=0.014);与血沉(ESR)无相关性(r=0.098,P=0.464)。结论S100A8/A9可能参与了狼疮性肾炎的发生发展过程。动态监测LN患者血清S100A8/A9水平,有助于了解狼疮活动情况以及肾脏损害程度,对治疗方案的选择、疗效评估可能具有一定的临床指导意义。

Objective To investigate level of S100A8/A9 in serum of patients with lupus nephritis(LN)and analyze the relation between S100A8/A9 and clinical parameters.Methods There were 50 female patients and 8 male patients with LN.Patients with LN(LN group)were divided into LN active group with more than 10 points(n=38)and LN inactive group with less than 10 points(n=20)by systemic lupus erythematosus disease activity index.Thirty healthy controls(control group)were individually matched for sex,age and body mass index.Serum levels of S100A8/A9 of LN patients were detected by enzyme-linked immunosorbent assay,the clinical data of LN patients were collected.Results①Serum level of S100A8/A9 was significantly higher in LN group than those of control group(P<0.01).②Serum level of S100A8/A9 was significantly higher in active LN group than in inactive LN group and healthy group(P<0.01).Serum level of S100A8/A9 was not significantly higher in inactive LN group than in control group(P>0.05).③Serum level of S100A8/A9 was positively correlated with anti-dsDNA,C-reactive protein,serum creatinine,24-hour urine protein and SLEDAI scores(r=0.27,P=0.04;r=0.4,P=0.002;r=0.38,P=0.003;r=0.30,P=0.02;r=0.90,P=0.000).Serum level of S100A8/A9 was negatively correlated with complement C3,C4 and creatinine clearance(r=-0.28,P=0.036;r=-0.38,P=0.036;r=-0.322,P=0.014).There was no correlation between serum level of S100A8/A9 and erythrocyte sedimentation rate(r=0.098,P=0.464).Conclusions S100A8/A9 may be involved in the occurrence and development of lupus nephritis.Dynamic observation of serum S100A8/A9 level contributes to monitor LN activity,evaluates the severity of kidney damage,which has clinical significances for treatment options,efficacy evaluation in LN patients in a way.