系统性红斑狼疮患者抗C1q抗体与疾病活动和细胞免疫功能的相关性  

Correlation between anti-C1q antibody and disease activity and cellular immune function in patients with systemic lupus erythematosus

作　　者：董洋 尤针针 曹慧霞 阎磊 张翥 邵凤民 Dong Yang;You Zhenzhen;Cao Huixia;Yan Lei;Zhang Zhu;Shao Fengmin(Department of Nephrology,Henan Provincial People′s Hospital,Central China Fuwai Hospital,Henan Provincial Clinical Research Center for Kidney Disease,Henan Key Laboratory of Nephrology and Immunology,Central China Fuwai Hospital of Zhengzhou University,Zhengzhou 451464,China;Department of Nephrology,Henan Provincial People′s Hospital,Henan Provincial Clinical Research Center for Kidney Disease,Henan Key Laboratory of Nephrology and Immunology,Zhengzhou University People′s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院肾内科,阜外华中心血管病医院肾内科,河南省肾病临床医学研究中心,河南省肾脏病免疫重点实验室,郑州大学阜外华中心血管病医院,郑州451464 [2]河南省人民医院肾内科,河南省肾病临床医学研究中心,河南省肾脏病免疫重点实验室,郑州大学人民医院,郑州450003

出　　处：《中国医师杂志》2023年第1期37-42,共6页Journal of Chinese Physician

基　　金：河南省重大公益专项(201300310700);河南省医学科技攻关计划(LHGJ20210129)。

摘　　要：目的评估系统性红斑狼疮(SLE)患者抗C1q抗体与疾病活动和细胞免疫功能的相关性。方法收集2017年6月至2018年2月河南省人民医院收治的134例SLE患者及90例健康体检者的临床资料及检验指标,采用酶联免疫吸附法(ELISA)测定抗C1q抗体水平,采用流式细胞术测定淋巴细胞亚群,根据系统性红斑狼疮疾病活动指数(SLEDAI-2K)评分将SLE患者分为活动组和非活动组,依据有无肾脏受累将SLE患者分为LN组和非LN组。比较各组研究对象的抗C1q抗体及淋巴细胞亚群水平,分析抗C1q抗体与疾病活动和淋巴细胞的相关性,评价抗C1q抗体和抗双链DNA(dsDNA)抗体对SLE疾病活动的预测价值。结果SLE组的抗C1q抗体水平及T细胞百分比、Ts细胞百分比高于对照组,Th细胞百分比、NK细胞百分比、T细胞计数、Th细胞计数、B细胞计数、NK细胞计数低于对照组(均P<0.05);活动组抗C1q抗体水平高于非活动组,T细胞计数、Ts细胞计数、Th细胞计数、B细胞计数、NK细胞计数低于非活动组(均P<0.05);LN组抗C1q抗体水平高于非LN组,T细胞计数、Ts细胞计数、Th细胞计数、B细胞计数、NK细胞计数低于非LN组,差异均有统计学意义(均P<0.05)。相关性分析示:年龄、HB、C3、C4、T细胞计数、Th细胞计数、B细胞计数、NK细胞计数与抗C1q抗体呈负相关,SLEDAI-2K、CRP、ESR、抗dsDNA抗体与抗C1q抗体呈正相关(均P<0.05)。受试者工作特征(ROC)曲线分析结果显示:抗C1q抗体单独检测时预测SLE疾病活动曲线下面积(AUC)为0.702,灵敏度为0.547,特异度为0.827,与抗dsDNA抗体联合检测时AUC为0.761,灵敏度为0.756,特异度为0.691,二者联合预测SLE疾病活动优于单项。结论抗C1q抗体与疾病活动和细胞免疫功能紊乱密切相关,在SLE疾病活动中有一定的预测价值。Objective To evaluate the correlation between anti-C1q antibody and disease activity and cellular immune function in patients with systemic lupus erythematosus(SLE).Methods The clinical data and test indexes of 134 patients with SLE and 90 healthy people who were admitted to Henan Provincial People′s Hospital from June 2017 to February 2018 were collected.The level of anti-C1q antibody was measured by enzyme-linked immunosorbent assay(ELISA),and lymphocyte subsets were measured by flow cytometry.According to the score of Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)-2K,SLE patients were divided into active and inactive groups,and SLE patients were divided into LN group and non-LN group according to the presence or absence of kidney involvement.The levels of anti-C1q antibodies and lymphocyte subsets were compared among the three groups,and correlations between anti-C1q antibodies and disease activity and lymphocytes were analyzed.The predictive value of anti-C1q antibodies and anti double stranded DNA(dsDNA)antibodies for SLE disease activity was evaluated.Results The anti-C1q antibody level,percentage of T cells and Ts cells in SLE group were higher than those in control group,while the percentage of Th cells,percentage of NK cells,T cell count,Th cell count,B cell count and NK cell count in SLE group were lower than those in control group(all P<0.05);The anti-C1q antibody level in the active group was higher than that in the inactive group,and the counts of T cells,Ts cells,Th cells,B cells and NK cells were lower than those in the inactive group(all P<0.05);The anti-C1q antibody level in LN group was higher than that in non-LN group,and the T cell count,Ts cell count,Th cell count,B cell count,NK cell count were lower than that in non-LN group,with statistically significant difference(all P<0.05).Correlation analysis showed that age,hemoglobin(HB),C3,C4,T cell count,Th cell count,B cell count and NK cell count were negatively correlated with anti-C1q antibody,while SLEDAI-2K,C-reactive protein(

关 键 词：红斑狼疮 系统性 抗C1Q抗体 免疫 细胞 

分 类 号：R593.241[医药卫生—内科学]