狼疮肾炎患者血清抗核小体抗体水平检测及其临床意义  

Clinical significance of antinucleosome antibody in patients with lupus nephritis

作　　者：许武红[1] 邹原方[1] 关晓东[1] 梁翔[1] 陈科全[2] 

机构地区：[1]中山大学附属东华医院肾内风湿科,广东东莞523000 [2]广州医学院附属第一医院消化科

出　　处：《中国医师进修杂志》2012年第4期26-28,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨血清抗核小体抗体（AnuA）水平与狼疮肾炎活动性、肾脏病理改变的关系及其治疗前后的变化。方法用酶联免疫吸附法检测活动期狼疮肾炎患者40例（观察组）和同期健康体检者40例（对照组）血清AnuA水平，分析其与系统性红斑狼疮疾病活动指数（SLEDAI）、肾脏病理改变及其他实验室参数的相关性，并比较狼疮肾炎患者治疗前后血清AnuA水平的变化。结果观察组治疗前血清AnuA水平为（110．23±80．48）ku／L，较对照组的（10．45±8．20）ku几明显升高（P〈0．05）；40例狼疮肾炎患者均行。肾穿刺活检，Ⅱ型4例，Ⅲ型8例，Ⅳ型23例，Ⅴ型5例。经KmskM．Wallis秩和检验显示，各病理类型间血清AnuA水平比较差异有统计学意义（P〈0．05），其中Ⅳ型血清AnuA水平显著高于其他病理类型（P〈0．05）；血清AnuA水平与SLEDAI、尿蛋白定量及抗双链DNA（dsDNA）抗体滴度呈正相关性（r=0．462、0．521、0．394，P〈0．05），与补体C。、C。水平呈负相关性（r=-0．403、-0．489，P〈0．05）；观察组治疗后血清AnuA水平为（32．45±18．31）ku几，较治疗前[（110．23±80．48）kU／L]明显降低（P〈0．05）。结论血清AnuA水平不仅与狼疮肾炎活动性相关，而且在一定程度上能反映肾脏病变程度，检测血清AnuA水平可以为临床治疗及判断预后提供重要依据。Objective To analyze the correlation between serum antinucleosome antibody（AnuA） and renal pathological characteristic, disease activity as well as some laboratory tests in patients with lupus nephritis （LN）. Methods Serum AnuA levels were detected by enzyme-linked immunosorbant assay in 40 patients with LN （observation group） and 40 healthy people （control group）. Renal biopsy was examined in all LN patients. The relationships between serum AnuA level and systemic lupus erythematosus disease activity index （SLEDAI）,renal pathohistology,laboratory parameters were analyzed. Restflts The serum AnuA level in observation group before treatment was significantly higher than that in control group [ （ 110.23 ± 80.48） kU/L vs. （ 10.45 ± 8.20） kU/L,P 〈 0.05 ]. Four cases of renal biopsies were class I1,8 cases were class III , 23 cases were class IV, and 5 cases were class . Serum AnuA level had significant difference between each class by Kruskal-Wallis rank sum test （P 〈 0.05）, and serum AnuA level of class IV was the highest （ P 〈 0.05）. Serum AnuA level had positive correlation with SLEDAI,urine protein quantitation and anti-double strands DNA antibody （r =0.462,0.521,0.394,P 〈0.05）,negative correlation with complement C3 and C4 levels （r = -0.403,-0.489,P 〈 0.05）. Serum AnuA level after treatment [ （32.45 ± 18.31 ） kU/L ] was significantly decreased than that before treatment [ （ 110.23 ± 80.48） kU/L ] （P 〈 0.05 ）. Conclusions Serum AnuA level is not only a good index of LN activity,but also reflect renal involvement. That serial measurement of serum AnuA level may provide better clinical strategies for the therapy.

关 键 词：狼疮肾炎 治疗 抗核小体抗体 

分 类 号：R593.241[医药卫生—内科学]