系统性红斑狼疮患者血清C1q抗体的检测及临床意义  

The determination of anti-C1q antibodies and its significance in patients with systemic lupus erythematosus

作　　者：蔡小燕[1] 杨岫岩[2] 陈小辉[1] 梁柳琴[2] 尹培达[2] 关明媚[1] 秦曙光[3] 傅君舟[3] 

机构地区：[1]广州市第一人民医院风湿科,510180 [2]中山大学附属第一医院风湿科 [3]广州市第一人民医院肾内科,510180

出　　处：《中华风湿病学杂志》2004年第8期481-484,共4页Chinese Journal of Rheumatology

摘　　要：目的研究C1q抗体与系统性红斑狼疮(SLE)病情活动和脏器损害的相关性,探讨C1q抗体对SLE疗效及预后的影响.方法用酶联免疫吸附试验(ELISA)检测86例活动期SLE患者血清中的C1q抗体,并对全部病例进行随访,以尿蛋白转阴性和病情初步缓解为随访终点,每半个月进行1次终点的评估.结果56例(65%)SLE患者血清C1q抗体阳性,抗体水平(83+39)U/ml;血清C1q抗体浓度与SLEDAI评分、尿蛋白含量以及抗dsDNA抗体滴度呈正相关(P＜0.001),与补体C3、C4水平呈负相关(P＜0.001);C1q抗体(+)组患者的肾损害发生率明显高于C1q抗体(-)组(P＜0.001);C1q抗体浓度和补体C3是影响SLE疗效的独立因素[相关危险度(RR值)0.99,95%可信区间(CI)0.98～0.997,P=0.010和RR值3.18,95%CI 1.05～9.65,P=0.041];C1q抗体(+)与C1q抗体(-)的狼疮肾炎患者尿蛋白转阴的时间经Log-rank检验差异有显著性(X2=4.10,P=-0.0428).结论C1q抗体与SLE的发生、发展密切相关.C1q抗体不仅反映SLE病情的活动性,而且对判断脏器损害情况、评价疗效及预后均有重要意义.Objective To study the relationship between C1q antibodies and disease activity as well as visceral involvement in patients with systemic lupus erythematosus (SLE), and analyze the influence of C1q antibodies to treatment and prognosis of SLE. Methods Serum C1q antibodies were detected by enzyme-linked immunosorbant assay(ELISA) in 86 patients with SLE, followed by further regular follow-up until preliminary remission had occured. Results Fifty-six of 86 patients (65%) were anti-C1q antibodies positive, the level was (83±39)U/ml. Positive correlation was found between serum C1q antibodies concentration and SLEDAI values, proteinuria as well as titers of anti-dsDNA (P<0.001) .Whereas negative correlation was found between serum C1q antibodies concentration and level of C3, C4(P<0.001). The incidence of renal involvement in patients with positive C1q antibodies was higher than that in C1q antibodies negative group (P<0.001). Anti-C1q antibodies concentration and C3 level were the influential factors for the therapeutic effect of SLE(RR 0.99,95%CI 0.98~0.997,P=0.010 and RR 3.18,95%CI 1.05~9.65,P=0.041). Comparing the recovery time of proteinuria with Kaplan-Meier estimate and Log-rank test, significant difference was found between anti-C1q (+) and anti-C1q (-) group (?字2=4.10, P=0.0428). Conclusion C1q antibodies is closely related to the pathogenesis of SLE. It can not only reflect disease activity, but also act as a useful marker to predict visceral involvement, treatment efficacy and prognosis.

关 键 词：系统性红斑狼疮 血清 C1Q抗体 检测 预后 

分 类 号：R593.24[医药卫生—内科学]