自身抗体联合检测与狼疮肾炎严重度的相关性分析

Analysis of the correlation between combined detection of auto-antibodies and the severity of lupus nephritis

目的分析抗双链DNA(anti-dsDNA)抗体、抗核小体(anti-nucleosome)抗体及抗组蛋白(anti-histone)抗体联合阳性与系统性红斑狼疮(systemic lupus erythematosus,SLE)并发狼疮肾炎(lupus nephritis,LN)严重度的相关性.方法收集2009年1月至2018年6月来自白求恩国际和平医院的SLE患者490例,其中LN组204例,非LN组286例.采用免疫渗滤法检测血清中的自身抗体,尿沉积法检测24 h尿蛋白定量,自动分析仪分析血清肌酐(serum creatinine,Scr)和尿素氮(blood urea nitrogen,BUN)水平.结果 SLE患者LN组抗dsDNA抗体(64.7%比37.1%,P<0.05),抗核小体抗体(60.5%比30.0%,P<0.05)及抗组蛋白抗体(47.3%比21.7%,P<0.05)比率高于非LN组.LN组抗双链DNA、抗核小体、抗组蛋白同时阳性(三阳性)比率显著高于非LN组(38.24%比19.58%,P<0.05).三阳性LN患者与非三阳性LN患者肾功能比较结果显示,24 h尿蛋白(2.88比1.02,P<0.05),Scr(83.16比57.10,P<0.05),BUN(7.37比5.16,P<0.05)显著高于非三阳性组.结论抗双链DNA、抗核小体及抗组蛋白同时阳性预示着SLE患者更易患LN并且对肾脏损伤程度更严重.

Objective To analyze the correlation between the combined positive of anti-double stran-ded DNA(anti-dsDNA),anti-nucleosome and anti-histone antibody and the severity of systemic lupus erythema-tosus (SLE)complicated with lupus nephritis(LN). Method Total of 490 SLE(204 LN and 286 non-LN) were collected from Bethune International Peace Hospital from 2009 January to 2018 June. The auto-antibodies in serum were measured by immunofiltration,24 h urine protein was detected by urine deposition method. Serum creatinine(Scr)and blood urea nitrogen(BUN)levels were analyzed by an automatic analyzer. Results Com-pared to non-LN groups,the ratio of anti-dsDNA (64. 7% vs. 37. 1%,P < 0. 05),anti-nucleosome (60. 5% vs. 30. 0%,P < 0. 05)and anti-histone (47. 3% vs. 21. 7%,P < 0. 05)antibodies in SLE patients were higher in LN groups. The simultaneous positive rates of anti-dsDNA,anti-nucleosome and anti-histone (three-positive) was significantly higher in LN patients than in the non-LN patients (38. 24% vs. 19. 58%,P < 0. 05). The 24-hour urinary protein (2. 88 vs. 1. 02,P < 0. 05),Scr(83. 16 vs. 57. 10,P < 0. 05)and BUN(7. 37 vs. 5. 16,P < 0. 05)were significantly higher in three-positive LN group than in non three-positive group. Conclusions Simultaneous positive of anti-dsDNA,anti-nucleosome and anti-histone antibodies may indicate that SLE patients are prone to develop LN and have more severe renal injury.