【摘要】：目的：探討狼瘡性腎炎(LN)患者腎組織中抗-Clq抗體(C1qAb)與系統(tǒng)性紅斑狼瘡腎損害的相關(guān)性及組織中抗AnuA、抗-dsDNA抗體、ANCA、ANA及抗Sm抗體等自身抗體與狼瘡性腎炎疾病活動性的關(guān)系,結(jié)合其他活動性指標(biāo)的相關(guān)分析,單獨(dú)或聯(lián)合檢測在狼瘡性腎炎診斷中的價(jià)值,抗-Clq抗體在狼瘡性腎炎不同分型的表達(dá),不同程度抗-Clq抗體在疾病狼瘡性腎炎疾病活動性的關(guān)系。方法：檢測129例行腎穿活檢患者,根據(jù)是否出現(xiàn)抗-C1q抗體,分為抗-C1q抗體陽性組(n=64例)及抗-Clq抗體陰性組(n=65例),同時(shí)記錄系統(tǒng)性紅斑狼瘡患者的各種臨床表現(xiàn),檢測其他自身抗體(抗核小體抗體、抗核抗體、抗dsDNA抗體、抗中性粒細(xì)胞抗體、抗Sm抗體)和相關(guān)實(shí)驗(yàn)室指標(biāo)(血細(xì)胞計(jì)數(shù)、血沉、補(bǔ)體、24小時(shí)尿蛋白定量、腎功能等)。結(jié)果：抗-Clq抗體與年齡、病程、血沉、血清球蛋白、血清尿素氮、血清肌酐無相關(guān)性。與補(bǔ)體C3、補(bǔ)體C4、、血紅蛋白、血清白蛋白呈負(fù)相關(guān)性；與24小時(shí)尿蛋白定量、腎小球率過濾、甘油三酯、SLEDAI評分呈正相關(guān)性。與抗-dsDNA抗體、抗-Sm抗體、抗核抗體、抗核小體抗體、抗中性粒細(xì)胞抗體這五種自身抗體有一致性。對活動性狼瘡性腎炎的診斷以抗-Clq抗體+抗核小體抗體抗體聯(lián)合檢測的方案為優(yōu)�？�-Clq抗體與SLEDAI評分、AI評分有顯著正相關(guān)性,Ⅲ型及Ⅳ型狼瘡性腎炎患者組織中抗-C1q抗體表達(dá)高于其他分型,故被認(rèn)為強(qiáng)活動性。陽性程度的增加,活動性越強(qiáng)�？�-C1q抗體(++)組患者血清補(bǔ)體水平顯著降低；抗-C1q抗體(+++)組患者患有更重的低補(bǔ)體血癥、SLEDAI評分和AI評分的逐漸增加、腎小球率過濾的逐漸下降,腎功能損害的危險(xiǎn)更大。結(jié)論：抗Clq抗體在系統(tǒng)性紅斑狼瘡患者腎臟損害的發(fā)生,發(fā)展中起重要的作用,與腎臟病變程度及疾病活動性有密切的相關(guān)性,在LN的診斷中有重要意義。
[Abstract]:Objective: to investigate the relationship between anti-Clq antibody (C1qAb) in renal tissue and renal damage in systemic lupus erythematosus (SLE) in patients with lupus nephritis (LN) and the anti-AnuA, anti-dsDNA antibody (ANCA,) in tissues of patients with lupus nephritis. The relationship between autoantibodies such as ANA and anti Sm antibodies and the activity of lupus nephritis. Combined with the correlation analysis of other active indexes, the value of single or combined detection in the diagnosis of lupus nephritis. The expression of anti-Clq antibody in different types of lupus nephritis and the relationship between anti-Clq antibody and disease activity of lupus nephritis. Methods: according to the presence of anti-C1q antibody, 129 renal biopsy patients were divided into two groups: 64 patients with positive anti-C1q antibody and 65 patients with negative anti-C1q antibody. The clinical manifestations of patients with systemic lupus erythematosus were recorded. Other autoantibodies (anti-nucleosome antibody, antinuclear antibody, anti-dsDNA antibody, anti-neutrophil antibody, anti-Sm antibody) and related laboratory indexes (blood cell count, erythrocyte sedimentation rate, complement, 24 hours urine protein quantification, renal function, etc.) were detected. Results: there was no correlation between anti-Clq antibody and age, course of disease, erythrocyte sedimentation rate, serum globulin, serum urea nitrogen, serum creatinine. There was a negative correlation with complement C _ 3, complement C _ 4, hemoglobin and serum albumin, and a positive correlation with 24 hour urinary protein quantification, glomerular filtration, triglyceride and SLEDAI score. It is consistent with five autoantibodies: anti-dsDNA antibody, anti-Sm antibody, anti-nucleosome antibody and anti-neutrophil antibody. In the diagnosis of active lupus nephritis, the combined detection of anti-Clq antibody and anti nucleosome antibody was the best. There was a significant positive correlation between anti-C1q antibody and SLEDAI score and AI score. The expression of anti-C1q antibody in type 鈪，

本文編號：2404414