补体C3、补体C4和C反应蛋白在系统性红斑狼疮活动和感染中的临床价值  

Clinical significance of complement C3 and C4 and C-reactive protein in the flare and infection of systemic lupus erythematosus

作　　者：唐仕超[1] 王赓[1] 张志国[1] 刘耀阳[1] 徐沪济[1] 

机构地区：[1]第二军医大学长征医院风湿免疫科,上海200003

出　　处：《第二军医大学学报》2016年第4期397-400,共4页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金青年项目(81302578)~~

摘　　要：目的通过分析系统性红斑狼疮(systemic lupus erythematosus,SLE)患者疾病活动和合并感染时的血清学特点,探讨补体和C反应蛋白(C-reactive protein,CRP)的临床意义。方法对2011年至2014年在我科住院且资料完整的63例SLE患者的临床资料进行回顾性分析,分别根据是否合并感染和SLE疾病活动指数(systemic lupus erythematosus disease activity index,SLEDAI)进行分组,比较感染组(n=20)和非感染组(n=43)以及活动组(n=44)和非活动组(n=19)CRP、红细胞沉降率(erythrocyte sedimentation rate,ESR)、补体和免疫球蛋白的差异,并分析SLEDAI与血清学指标的相关性。结果感染组中的CRP、ESR、IgA和SLEDAI高于非感染组(P<0.05);活动组中的ESR、IgG高于非活动组,而补体C3低于非活动组(P<0.05)。相关分析发现SLEDAI与补体C3呈负相关(r=-0.666,P<0.01),而与CRP和补体C4无相关性(r=0.073,r=0.143;P>0.05)。结论 SLE患者在感染时CRP升高,C3、C4未降低或降低不明显;在疾病活动时,C3降低,C4未降低或降低不明显,CRP未升高或升高不明显。提示CRP和C3的变化对SLE患者的病情活动或感染有重要价值。Objective To evaluate the clinical values of complement C3 and C4 and C-reactive protein （CRP） in the differential diagnosis of disease relapse and infection in systemic lupus erythematosus （SLE）. Methods Sixty-three hospitalized SLE patients during 2011-2014 were retrospectively analyzed in this study. Patients were grouped according to the presence of infection and SLE disease activity index （SLEDAI）. The laboratory findings, including CRP, erythrocyte sedimentation rate （ESR）, complement and immunoglobulin were compared between the infected group （n= 20） and non-infected group （n= 43） and the flare group （n= 44） and inactive group （n= 19）. Correlation analysis was also made between SLEDAI and serum markers. Results The levels of CRP, ESR, IgA, and SLEDAI in the infection group were significantly higher than those of the non-infection group （P〈0. 05）. The levels of ESR and IgG in the flare group were significantly higher and C3 was significantly lower than those in the inactive group （P〈0. 05）. Correlation analysis found that C3 was negatively correlated with SLEDAI （r=-0. 666, P〈0. 01）, but CRP was not correlated with C4 （r=0. 073, r=0. 143; P〉0. 05）. Conclusion CRP is elevated when SLE patients have infection, but C3 and CA have no decrease or only with slight decrease. During flare of SLE patients, C3 is decreased and CA has no obvious decrease, with CRP not elevated or slightly elevated. It is indicated that C3 and CRP are valuable in the differential diagnosis of disease relapse and infection in SLE.

关 键 词：系统性红斑狼疮 补体C3 补体C4 C反应蛋白 感染 

分 类 号：R593.241[医药卫生—内科学]