尿可溶性CD163水平对狼疮肾炎严重程度和疾病活动性的临床评价  

Clinical evaluation of urinary soluble CD163 level on the severity and disease activity of lupus nephritis

作　　者：魏斐菲 徐光 张濛 王柳青 谷裕 王建刚[1] 陶雅非[1] 李海剑[1] WEI Fei-fei;XU Guang;ZHANG Meng;WANG Liu-qing;GU Yu;WANG Jian-gang;TAO Ya-fei;LI Hai-jian(Department of Rheumatology and Immunology,Nanyang Central Hospital,Nanyang,Henan 473000,China;Department of Nephrology,Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院风湿免疫科,河南南阳473000 [2]南阳市中心医院肾病内科,河南南阳473000

出　　处：《医药论坛杂志》2023年第19期27-32,共6页Journal of Medical Forum

摘　　要：目的探讨尿可溶性CD163(usCD163)水平对狼疮肾炎(lupus nephritis,LN)严重程度和疾病活动性的临床价值。方法选取2020年1月至2022年7月诊治的LN患者152例,其中活动性LN 86例,非活动性LN 66例,采用ELISA法检测usCD163,分析usCD163水平与系统性红斑狼疮疾病活动度评分(SLEDAI),肾脏系统性红斑狼疮疾病活动度评分(rSLEDAI),系统性红斑狼疮国际合作组织肾活动评分(SLICC RAS)、病理活性指数(AI)和慢性指数(CI)的相关性。结果活动性LN组usCD163水平高于非活动性LN。usCD163与SLEDAI、rSLEDAI和SLICC RAS评分正相关。活动性LN患者中,usCD163与24 h尿蛋白(UP)(r=0.419,P<0.001)和红细胞沉降率(ESR)(r=0.409,P<0.001)正相关,与补体C3(ρ=0.361,P<0.001)负相关。增生性LN usCD163水平高于膜性LN。usCD163与AI(r=0.300,P=0.005)及新月体(r=0.319,P=0.003)和透明沉积物(r=0.286,P=0.009)正相关。24 h UP>3.0g/24 h患者中,usCD163与AI(r=0.389,P=0.008)和透明沉积物(r=0.418,P=0.006)正相关。24 h UP≤3.0 g/24 h患者中,usCD163与新月体(r=0.328,P=0.040)正相关。结论usCD163水平与LN患者的疾病活动性和病理特征相关,在24 h UP>3.0 g/24 h的活动性LN患者中相关性尤为明显,可作为活动性LN的潜在生物标志物。Objective To explore the clinical value of urinary soluble CD163(usCD163)level in the severity and dis⁃ease activity of lupus nephritis.Methods Totally 152 patients with LN from January 2020 to July 2022 were selected,including 86 active LN and 66 inactive LN.usCD163 was detected by ELISA,Correlation between pathological activity index(AI)and chronic index(CI)and usCD163 and SLEDAI,rSLEDAI,SLICC RAS were analyzed.Results The level of usCD163 in the active LN group was higher than that of the inactive LN group.UsCD163 was positively correla⁃ted with SLEDAI,rSLEDAI,and SLICC RAS scores.UsCD163 and 24-hour urinary protein(UP)in active LN pa⁃tients(r=0.419,P<0.001)and Erythrocyte sedimentation rate(ESR)(r=0.409,P<0.001)positively correlated with complement C3(r=0.361,P<0.001)was negatively correlated.The level of proliferative LN usCD163 was high⁃er than that of membranous LN.UsCD163 and AI(r=0.300,P=0.005)and crescent(r=0.319,P=0.003)and transparent sediment(r=0.286,P=0.009)was positively correlated.In patients with 24-hour UP>3.0 g/24 h,us⁃CD163 and AI(r=0.389,P=0.008)and transparent sediment(r=0.418,P=0.006)was positively correlated.In patients with 24-hour UP≤3.0 g/24 h,usCD163 and crescent body(r=0.328,P=0.040)was positively correla⁃ted.Conclusion usCD163 is related to the disease activity and pathological characteristics of LN patients,especially in active LN patients with 24 h UP>3.0 g/24 h,and can be used as a potential biomarker of active LN.

关 键 词：系统性红斑狼疮 狼疮性肾炎 尿可溶性CD163 疾病活动度 

分 类 号：R593.242[医药卫生—内科学]