神经精神性狼疮患者血清抗N-甲基-D-天[门]冬氨酸受体亚单位2A抗体水平及其临床意义  

Levels and clinical significance of serum anti-N-methyl-D-aspartate receptor 2A subunit antibodies in patients with neuropsychiatric systemic lupus erythematosus

作　　者：曲航 黄宇 廖浩 裴文迪 黄琴[2] QU Hang;HUANG Yu;LIAO Hao;PEI Wen-di;HUANG Qin(The Second School of Clinical Medicine,Southern Medical University,Guangzhou 510282,China;Department of Rheumatology and Immunology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学第二临床医学院,广东省广州市510282 [2]南方医科大学南方医院风湿免疫科,广东省广州市510515

出　　处：《广西医学》2019年第17期2149-2152,2156,共5页Guangxi Medical Journal

基　　金：国家自然科学基金(81801624);南方医科大学大学生创新计划项目(201812121288)

摘　　要：目的 探讨神经精神性狼疮(NPSLE)患者血清抗N-甲基-D-天[门]冬氨酸受体亚单位2A抗体(抗NR2A抗体)水平及其临床意义。方法 将73例活动期系统性红斑狼疮(SLE)患者分为NPSLE组36例和非NPSLE组37例。比较两组自身抗体及补体水平。评估NPSLE患者抗NR2A抗体水平与SLE疾病活动指数2000(SLEDAI-2000)评分、抗双链脱氧核糖核酸(dsDNA)抗体及补体水平的相关性。结果 NPSLE组患者的SLEDAI-2000评分、抗NR2A抗体及抗dsDNA抗体水平均高于非NPSLE组(均P<0.05),但认知障碍与无认知障碍NPSLE患者间抗NR2A抗体水平差异无统计学意义(P>0.05)。NPSLE组中,抗NR2A抗体水平与SLEDAI-2000评分、抗dsDNA抗体水平呈正相关,与C3、C4水平呈负相关(P<0.05)。抗核糖体P蛋白抗体(ARPPA)阳性的SLE患者抗NR2A抗体水平高于ARPPA阴性SLE患者(P<0.05)。结论 抗NR2A抗体在NPSLE的发病过程中起重要作用,且与疾病活动度有关,但可能与认知障碍无关。Objective To explore the levels and clinical significance of serum anti-N-methyl-D-aspartate receptor 2A subunit(anti-NR2A) antibodies in patients with neuropsychiatric systemic lupus erythematosus(NPSLE). Methods Seventy-three patients with active systemic lupus erythematosus(SLE) were divided into NPSLE group(36 cases) and non-NPSLE group(37 cases).The levels of antibodies and complements were compared between the two groups.The correlation of anti-NR2A antibodies levels with SLE disease activity index-2000(SLEDAI-2000) score, anti -double-stranded-DNA(anti-dsDNA) antibodies or complements levels was assessed in patients with NPSLE. Results The NPSLE group had higher SLEDAI-2000 score and higher levels of anti-NR2A antibodies and anti-dsDNA antibodies than the non-NPSLE group(all P <0.05),however,no statistically significant difference was found in levels of anti-NR2A antibodies between NPSLE patients with cognitive disorder and without cognitive disorder( P >0.05).In the NPSLE group,anti-NR2A antibodies levels positively correlated with SLEDAI-2000 score or anti-dsDNA antibodies levels,but negatively correlated with complement C3 or C4 level( P <0.05).The levels of anti-NR2A antibodies in SLE patients with positive anti-ribosomal P protein antibody(ARPPA) were higher than those in SLE patients with negative ARPPA( P <0.05). Conclusion Anti-NR2A antibodies may play an important role in the pathogenesis of NPSLE,which are associated with activity of the disease,but may not correlate with cognitive disorder.

关 键 词：神经精神性狼疮 抗N-甲基-D-天[门]冬氨酸受体亚单位2A抗体 认知障碍 疾病活动 

分 类 号：R593.24[医药卫生—内科学]