抗中性粒细胞胞浆抗体与小儿系统性红斑狼疮活动性及狼疮性肾炎相关性分析  

Correlation analysis between anti-neutrophil cytoplasmic antibody and activity of systemic lupus erythematosus or lupus nephritis

作　　者：杨晓[1,2] 姜红[1] 

机构地区：[1]中国医科大学附属第一医院儿科,辽宁沈阳110001 [2]南京军区南京总医院儿科

出　　处：《中国实用儿科杂志》2013年第10期784-786,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨抗中性粒细胞胞浆抗体(ANCA)与小儿系统性红斑狼疮(SLE)活动性及狼疮性肾炎(LN)的相关性及临床意义。方法选择中国医科大学附属第一医院2009年6月至2012年9月初诊住院的≤18岁的SLE患儿共56例。收集患儿性别,发病年龄,临床症状包括皮肤血管炎、关节炎、发热、脱发、口腔溃疡、浆膜炎等临床资料,检测并记录患儿抗dsDNA抗体、抗核抗体(ANA)、抗Sm抗体、抗U1RNP抗体、抗SSA抗体、抗SSB抗体、补体C3、C4、血常规、尿系列、24h尿蛋白、尿微量蛋白等相关检验指标。其中25例尿蛋白异常的患儿完善肾组织活检。结果 (1)初诊SLE共56例患儿中ANCA阳性29例,全部为p-ANCA,阳性率为51.79%。所有患儿c-ANCA均为阴性。(2)ANCA阳性组和阴性组的临床表现、各项特异性自身抗体检测差异均无统计学意义(P>0.05),ANCA与初诊SLE患儿的疾病活动性指标相关性研究无统计学意义。(3)入选病例中,对25例尿蛋白异常的患儿进行了肾组织活检。其中ANCA阳性12例,ANCA阴性13例。结论 ANCA与初诊SLE及LN的病情无明显的相关性,故ANCA的检测对疾病活动性及肾脏受累程度的评估无统计学意义。Objective To study and discuss the relationship between antineutrophil cytoplasmic antibodies （ANCA） and activity of systemic lupus erythematosus （SLE） in children, as well as between ANCA and lupus nephritis, and the clinical value of ANCA in children with SLE. Methods Fifty-six children with SLE who were not more than 18 years old were recruited from the 1st Affiliated Hospital of China Medical University, and they were all first diagnosed during the period from Jun 2009 to Sep 2012. Their gender, age of onset, and clinical symptoms including cutaneous vaseuli- tis, arthritis, fever, hair loss, mouth ulcers, and serositis, etc. were collected,and the anti-dsDNA antibodies,antinu- clear antibodies （ANA）, anti-Sin antibodies, anti-U1RNP antibody, anti-SSA antibody, anti-SSB antibody and com- plement C3, C4, blood routine, urine Series, 24-hour urine protein, and urine protein test indicators, etc. were detect- ed and recorded. Totally 25 cases of children with urine protein abnormalities received renal biopsy. Results （ 1 ） 29 of 56 （51.79%） children showed positive ANCA, which were all p-ANCA. All children showed negative c-ANCA. （2） The clinical manifestations and specific autoantibodies showed no significant differences （P 〉 0.05） between ANCA pos- itive group and negative group. ANCA had no relation with the activity of SLE in children who were newly diagnosed. （3） 25 of 56 who were with urine protein abnormalities received renal biopsy. Twelve cases were ANCA positive, while 13 cases were negative ANCA. Conclusion ANCA has relation with neither the activity of SLE in children who are newly diagnosed nor the condition of LN. ANCA detection doesn＇ t have marked significance for the activity of SLE in children who are newly diagnosed, or for degree of LN.

关 键 词：抗中性粒细胞胞浆抗体 系统性红斑狼疮 狼疮性肾炎 儿童 

分 类 号：R72[医药卫生—儿科]