血清免疫球蛋白轻链在系统性红斑狼疮及狼疮性肾炎中的诊断效能及价值  

The Diagnostic Value of Serum Immunoglobulin Light Chain in Systemic Lupus Erythematosus and Lupus Nephritis

作　　者：刘岩[1] 黄婧 谢欣 许惠 杨艺员 高蕊[1] LIU Yan;HANG Jing;XIE Xin;XU Hui;YANG Yiyuan;GAO Rui(Department of Nuclear Medicine,the First Affiliated Hospital of Xi’an Jiaotong University School of Medicine,Xi’an 710061,China;Department of Rheumatology,the First Affiliated Hospital of Xi’an Jiaotong University School of Medicine,Xi’an 710061,China)

机构地区：[1]西安交通大学医学院第一附属医院核医学科,陕西西安710061 [2]西安交通大学医学院第一附属医院风湿免疫科,陕西西安710061

出　　处：《标记免疫分析与临床》2022年第12期2035-2038,共4页Labeled Immunoassays and Clinical Medicine

基　　金：陕西省自然科学基金(编号:2022JQ-761)。

摘　　要：目的探讨血清免疫球蛋白轻链在系统性红斑狼疮(SLE)及狼疮性肾炎(LN)中的诊断效能及价值。方法回顾性收集我院2020年2月至2021年6月临床确诊的129例系统性红斑狼疮(SLE)患者,根据SLE是否累及肾脏,分为单纯系统性红斑狼疮组(SLE)和狼疮性肾炎组(LN);选取我院健康体检的50例志愿者为对照组,对比分析血清补体C3、C4及免疫球蛋白轻链kappa(κ)、lambda(λ)在SLE、LN治疗前的诊断价值。结果(1)SLE患者血清补体C3、C4水平显著低于对照组(P<0.05),κ、λ轻链水平则显著高于对照组(P<0.05);而LN患者血清补体C3、C4及κ轻链水平均显著低于对照组(P<0.05),血清λ轻链水平在LN与对照组间差异无统计学意义(P>0.05);(2)血清κ、λ轻链水平在LN组均明显低于SLE组(P<0.05),而血清补体C3、C4水平在LN与SLE中差异无统计学意义(P>0.05);(3)血清λ轻链在非单纯V型及单纯V型LN阳性率明显高于κ(P<0.05);血清κ、λ轻链在II型+III型及IV型LN阳性率差异无统计学意义(P>0.05)。结论血清κ、λ轻链有助于SLE的诊断。血清λ轻链在明确非单纯V型、单纯V型LN中具有重要的临床价值。Objective To investigate the diagnostic value of immunoglobulin light chain in systemic lupus erythematosus(SLE)and Lupus nephritis(LN).Methods A retrospective study was performed among 65 patients with SLE and 64 patients with LN clinically diagnosed in our hospital from February,2020 to June,2021.According to whether SLE related with kidney,these patients were divided into SLE group(SLE)and LN group(LN).Fifty healthy volunteers from our hospital were selected as the control group during the same period.Levels of complement C3,C4,kappa(κ)and lambda(λ)in SLE,LN and the control group were analyzed.Results(1)Levels of complement C3 and C4 in SLE patients were significantly lower than those in the control group(P<0.05),while levels ofκandλlight chain were significantly higher than those in the control group(P<0.05).Levels of complement C3,C4 andκlight chain in serum of LN patients were significantly lower than those in the control group(P<0.05),while there was no significant difference in serumλlight chain between LN and the control group(P>0.05).(2)Levels of serumκandλlight chain in LN group were significantly lower than those in SLE group(P<0.05),while levels of serum complement C3 and C4 were not significantly different between LN and SLE group(P>0.05).(3)The positive rate of serumλlight chain for the diagnosis of non-pure V and pure V LN were significantly higher thanκ(P<0.05).There was no significant difference in the positive rate of serumκandλlight chain for the diagnosis of type II+III and type IV LN(P>0.05).Conclusion Serumκandλlight chain can be used as the diagnostic markers of SLE.Serumλlight chain has an important clinical value in the diagnosis of non-pure V and pure V LN.

关 键 词：KAPPA LAMBDA 狼疮性肾炎 系统性红斑狼疮 

分 类 号：R593.241[医药卫生—内科学]