ANCA相关性系统性小血管炎患者血清指标、内皮损伤标记物与肾损害的关系  

Relationship between serum indicators,endothelial injury markers and renal damage in patients with ANCA-associated systemic vasculitis

作　　者：刘维佳[1] 黄俊波[1] 

机构地区：[1]长江大学附属仙桃市第一人民医院肾内科,湖北仙桃433000

出　　处：《海南医学院学报》2016年第10期976-979,共4页Journal of Hainan Medical University

基　　金：2013年仙桃市科学技术局指导性科技研究与开发计划项目(2013-1)~~

摘　　要：目的:研究抗中性粒细胞胞浆抗体(ANCA)相关性系统性小血管炎患者血清指标、内皮损伤标记物与肾损害的关系。方法:选择ANCA相关性系统性小血管炎患者进行研究,筛选不合并肾损伤的患者30例作为抗中性粒细胞胞浆抗体相关性血管炎(AAV)组,合并肾损伤的患者30例作为肾损伤组,测定血清中自身抗体含量以及内皮损伤标记物含量。结果:肾损伤组患者血清中蛋白酶3(PR3)-ANCA、髓过氧化物酶(MPO)-ANCA的含量无明显差异(P>0.05),而抗溶酶体相关膜蛋白2(LAMP-2)抗体、抗内皮细胞抗体(AECA)的含量显著高于AAV组(P<0.05);肾损伤组患者血清中循环内皮细胞(CECs)、血管性假血友病因子(vWF)、E选择素(ES)和血管细胞黏附分子1(VCAM-1)的含量显著高于AAV组(P<0.05),血管内皮细胞中血栓调节蛋白(TM)和内皮型一氧化氮合酶(eNOS)的含量低于AAV组(P<0.05);肾损伤组患者的CKD分期越高、蛋白尿越明显,血清中CECs、vWF、ES、VCAM-1的含量越高,TM、eNOS的含量越低(P<0.05)。结论:ANCA相关性系统性小血管炎患者血清中自身抗体抗LAMP-2抗体、AECA以及内皮损伤标记物的含量异常与肾损害密切相关,可以用于病情评估。Objective：To study the relationship between serum indicators,endothelial injury markers and renal damage in patients with anti-neutrophil cytoplasmic antibody（ANCA）-associated systemic vasculitis.Methods：Patients with ANCAassociated systemic vasculitis were selected for study,30 cases of patients not complicated with renal damage were screened as ANCA-associated vasculitis（AAV）group and 30 cases of patients complicated with renal damage were screened as renal damage group,and then serum autoantibody contents and endothelial injury marker contents were detected.Results：Serum protease 3（PR3）-ANCA and myeloperoxidase（MPO）-ANCA contents of renal damage group were not significantly different from those of AAV group while anti-lysosomal-associated membrane protein 2（anti-LAMP-2）antibody（P〉0.05）while anti-endothelial cell antibody（AECA）contents were significantly higher than those of AAV group（P〈0.05）;serum circulating endothelial cells（CECs）,von Willebrand factor（vWF）,E-selectin（ES）and vascular cell adhesion molecule 1（VCAM-1）contents of renal damage group were significantly higher than those of AAV group while thrombomodulin（TM）and endothelial nitric oxide synthase（eNOS）contents were lower than those of AAV group（P〈0.05）;the higher the CKD stage in renal damage group,the more significant the albuminuria,the higher the serum CECs,vWF,ES and VCAM-1contents and the lower the TM and eNOS contents（P〈0.05）.Conclusion：Abnormal contents of serum autoantibody anti-LAMP-2antibody,AECA and endothelial injury markers in patients with ANCA-associated systemic vasculitis are closely related to renal damage and can be used for disease evaluation.

关 键 词：抗中性粒细胞胞浆抗体相关性血管炎 自身抗体 内皮损伤 肾损害 

分 类 号：R593.2[医药卫生—内科学]