狼疮性肾炎患者肾组织中抗-C1q抗体与疾病活动性的关系研究  

Relationship between Anti-C1q Antibody in Kidney Tissue of Lupus Nephritis Patients and Disease Activity

作　　者：古再丽努尔.赛来阿吉木 王梅红[1] 米娜瓦儿.玉诺斯 桑晓红[1] GUZAILINUER · Sailaiajimu WANG Mei - hong MINAWAER · Yunuosi SANG Xiao - hong(Department of Nephrology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Chin)

机构地区：[1]新疆医科大学第一附属医院肾病科,新疆乌鲁木齐市830054

出　　处：《中国全科医学》2016年第29期3545-3548,共4页Chinese General Practice

摘　　要：背景随着医学领域技术更新加快,国内外专家对抗-C1q抗体(抗-C1qAb)与狼疮性肾炎(LN)疾病活动性进行了较多研究,但由于新疆地区医疗技术薄弱,研究人才严重缺乏等原因,对此课题尚未开展系统的、完整的研究。目的探讨LN患者肾组织中抗-C1qAb与疾病活动性的关系。方法选取2006年7月—2013年7月于新疆医科大学第一附属医院肾病科住院行肾脏穿刺活检术的LN患者129例,根据患者肾组织中有无抗-C1qAb,分为抗-C1qAb阳性组(n=64)和抗-C1qAb阴性组(n=65),其中抗-C1qAb阳性患者根据肾组织中抗-C1qAb表达程度的不同可分为轻度组、中度组和重度组。记录患者临床表现,并抽取血液,检测红细胞沉降率(ESR)、球蛋白、血红蛋白(Hb)、血肌酐(Scr)、尿素氮(BUN)、清蛋白(Alb)、补体C_3、C_4水平。评估患者估算肾小球滤过率(eGFR),对系统性红斑狼疮(SLE)病情活动情况(SLEDAI)、LN活动性指数(AI)进行评分。结果两组患者性别、年龄、病程、收缩压(SBP)、舒张压(DBP)、ESR、球蛋白、Scr、BUN水平比较,差异均无统计学意义(P>0.05);抗-C1qAb阳性组Hb、Alb、C_3、C_4水平、eGFR低于抗-C1qAb阴性组,SLEDAI评分高于抗-C1qAb阴性组(P<0.05)。两组患者发热、颧部红斑、黏膜溃疡、关节痛/关节炎、心包炎、胸膜炎、管型尿、白细胞计数减少、血小板减少症发生率比较,差异均无统计学意义(P>0.05);抗-C1qAb阳性组蛋白尿、Hb减少、低C_3、低C_4发生率高于抗-C1qAb阴性组(P<0.05)。不同表达程度抗-C1qAb血清C_3、C_4水平、eGFR、SLEDAI、AI评分比较,差异均有统计学意义(P<0.001);其中抗-C1qAb轻度、中度、重度组血清C_3、C_4水平低于抗-C1qAb阴性组,AI评分高于抗-C1qAb阴性组;抗-C1qAb中度、重度组eGFR低于抗-C1qAb阴性组,SLEDAI评分高于抗-C1qAb阴性组;抗-C1qAb重度组血清C_3水平低于抗-C1qAb轻度组;抗-C1qAb中度组eGFR低于抗-C1qAb轻度组;抗-C1qAb中度、�Background With the accelerated development of medical technology,the experts at home and abroad have conducted a lot of research on the anti-C1 q antibody（ anti-C1qAb） and lupus nephritis（ LN） disease activity.Unfortunately,the medical technology is weak in Xinjiang region,and the lack of research personnel is serious,this issue has not been carried out systematically and completely. Objective To study the correlation between anti-C1qAb in kidney tissue of LN patients and disease activity. Methods 129 cases of LN patients who underwent renal biopsy in Department of Nephrology of the First Affiliated Hospital of Xinjiang Medical University from July 2006 to July 2013, were selected as study subjects.According to whether anti-C1qAb in the kidney tissue existed,cases were divided into anti-C1qAb positive group（ n = 64） and anti-C1qAb negative group（ n = 65）. According to expression level of anti-C1qAb in the kidney tissue,anti-C1qAb positive patients were divided into mild group,moderate group and severe group. The clinical manifestations of patients were recorded,the blood was extracted, erythrocyte sedimentation rate（ ESR）, levels of globulin, hemoglobin（ Hb）, serum creatinine（ Scr）,blood urea nitrogen（ BUN）,albumin（ Alb）,complement C3 and C4were measured. Estimated glomerular filtration rate（ e GFR）,the SLE disease activity（ SLEDAI）,and LN activity index（ AI） were calculated. Results There were no significant difference in gender, age, course of the disease, SBP, DBP, ESR, levels of serum globulin, Scr and BUN between two groups of patients（ P〈0. 05）. Levels of Hb, Alb, C3,C4,and e GFR in anti-C1qAb positive group were significantly lower than those in anti-C1qAb negative group,and the SLEDAI score of anti-C1qAb positive group was significantly higher than that of anti-C1qAb negative group（ P〈0. 05）. There were no significant difference in incidences of fever,malar rash,ulcers, arthritis pain / joint inflammation, pericarditis, pleurisy, tube type urine

关 键 词：红斑狼疮 系统性 狼疮肾炎 抗-C1q抗体 疾病活动性 

分 类 号：R593.242[医药卫生—内科学]