中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2013年
9期
611-615
,共5页
温晓宏%郑毅%陈珊珊%曾小峰
溫曉宏%鄭毅%陳珊珊%曾小峰
온효굉%정의%진산산%증소봉
狼疮肾炎%单核细胞化学吸引蛋白质1%中性粒细胞明胶酶相关脂质运载蛋白%肿瘤坏死因子样凋亡的微弱诱导剂
狼瘡腎炎%單覈細胞化學吸引蛋白質1%中性粒細胞明膠酶相關脂質運載蛋白%腫瘤壞死因子樣凋亡的微弱誘導劑
랑창신염%단핵세포화학흡인단백질1%중성립세포명효매상관지질운재단백%종류배사인자양조망적미약유도제
Lupus nephritis%Monocyte chemoattractant protein-1%Neutrophil gelatinase-associated lipocalin%Tumor necrosis factor-like weak inducer of apoptosis
目的 探讨狼疮肾炎患者体液中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、单核细胞趋化蛋白-1(MCP-1)和肿瘤坏死因子样凋亡的微弱诱导剂(TWEAK)水平的临床意义.方法 采用酶联免疫吸附法检测51例系统性红斑狼疮(SLE)患者的血清和尿中NGAL、MCP-1和TWEAK水平,其中狼疮肾炎27例、非狼疮肾炎24例.并采集临床资料.采用t检验、Mann-Whitney U检验、Pearson和Spearman 秩相关分析进行统计学分析.结果 ①血清NGAL水平狼疮肾炎组为(122±70)ng/ml高于非狼疮肾炎组(56±34)ng/ml (P＜0.01).血清NGAL与整体SLE疾病活动指数(SLEDAI)评分、肾外SLEDAI评分、肾SLEDAI评分、尿蛋白定量(24 h)、血肌酐水平呈正相关(r=-0.408、0.431、0.339、0.403和0.585,P均＜0.05),与血清C3呈负相关(r=-0.396,P＜0.01).尿NGAL水平与慢性指数呈正相关(r=0.719,P＜0.01).②血清MCP-1狼疮肾炎组(284±1 13) pg/ml高于非狼疮肾炎组(173±69)pg/ml,P＜0.01；尿MCP-1水平在狼疮肾炎组M=1154、(P75 41 178,P5 341)pg/mg肌酐高于非狼疮肾炎组M=456、(P75 714,P25 114)pg/mg 肌酐(P＜0.01).血清MCP-1水平与整体SLEDAI评分、肾外SLEDAI评分、肾SLEDAI评分、尿蛋白定量(24 h)、血肌酐水平均呈正相关(r=0.340、0.416、0.385、0.574和0.654,P均＜0.05),与血清C3水平呈负相关(r=-0.458,P＜0.01).尿MCP-1水平与全身SLEDAI评分、肾外SLEDAI评分、肾SLEDAI评分、血清抗dsDNA抗体、尿蛋白定量(24 h)、血肌酐水平均呈正相关(rs=0.448、0.429、0.459、0.412、0.375和0.419,P均＜0.05).尿MCP-1水平与慢性指数呈正相关(r=0.689,P＜0.01).③6例狼疮肾炎尿中可检测到TWEAK.结论 尿NGAL和MCP-1水平升高提示肾脏慢性损伤.血NGAL和血、尿MCP-1水平在狼疮肾炎活动时均明显升高,可用于监测狼疮肾炎病情活动.TWEAK临床意义需要进一步研究.
目的 探討狼瘡腎炎患者體液中性粒細胞明膠酶相關脂質運載蛋白(NGAL)、單覈細胞趨化蛋白-1(MCP-1)和腫瘤壞死因子樣凋亡的微弱誘導劑(TWEAK)水平的臨床意義.方法 採用酶聯免疫吸附法檢測51例繫統性紅斑狼瘡(SLE)患者的血清和尿中NGAL、MCP-1和TWEAK水平,其中狼瘡腎炎27例、非狼瘡腎炎24例.併採集臨床資料.採用t檢驗、Mann-Whitney U檢驗、Pearson和Spearman 秩相關分析進行統計學分析.結果 ①血清NGAL水平狼瘡腎炎組為(122±70)ng/ml高于非狼瘡腎炎組(56±34)ng/ml (P＜0.01).血清NGAL與整體SLE疾病活動指數(SLEDAI)評分、腎外SLEDAI評分、腎SLEDAI評分、尿蛋白定量(24 h)、血肌酐水平呈正相關(r=-0.408、0.431、0.339、0.403和0.585,P均＜0.05),與血清C3呈負相關(r=-0.396,P＜0.01).尿NGAL水平與慢性指數呈正相關(r=0.719,P＜0.01).②血清MCP-1狼瘡腎炎組(284±1 13) pg/ml高于非狼瘡腎炎組(173±69)pg/ml,P＜0.01；尿MCP-1水平在狼瘡腎炎組M=1154、(P75 41 178,P5 341)pg/mg肌酐高于非狼瘡腎炎組M=456、(P75 714,P25 114)pg/mg 肌酐(P＜0.01).血清MCP-1水平與整體SLEDAI評分、腎外SLEDAI評分、腎SLEDAI評分、尿蛋白定量(24 h)、血肌酐水平均呈正相關(r=0.340、0.416、0.385、0.574和0.654,P均＜0.05),與血清C3水平呈負相關(r=-0.458,P＜0.01).尿MCP-1水平與全身SLEDAI評分、腎外SLEDAI評分、腎SLEDAI評分、血清抗dsDNA抗體、尿蛋白定量(24 h)、血肌酐水平均呈正相關(rs=0.448、0.429、0.459、0.412、0.375和0.419,P均＜0.05).尿MCP-1水平與慢性指數呈正相關(r=0.689,P＜0.01).③6例狼瘡腎炎尿中可檢測到TWEAK.結論 尿NGAL和MCP-1水平升高提示腎髒慢性損傷.血NGAL和血、尿MCP-1水平在狼瘡腎炎活動時均明顯升高,可用于鑑測狼瘡腎炎病情活動.TWEAK臨床意義需要進一步研究.
목적 탐토랑창신염환자체액중성립세포명효매상관지질운재단백(NGAL)、단핵세포추화단백-1(MCP-1)화종류배사인자양조망적미약유도제(TWEAK)수평적림상의의.방법 채용매련면역흡부법검측51례계통성홍반랑창(SLE)환자적혈청화뇨중NGAL、MCP-1화TWEAK수평,기중랑창신염27례、비랑창신염24례.병채집림상자료.채용t검험、Mann-Whitney U검험、Pearson화Spearman 질상관분석진행통계학분석.결과 ①혈청NGAL수평랑창신염조위(122±70)ng/ml고우비랑창신염조(56±34)ng/ml (P＜0.01).혈청NGAL여정체SLE질병활동지수(SLEDAI)평분、신외SLEDAI평분、신SLEDAI평분、뇨단백정량(24 h)、혈기항수평정정상관(r=-0.408、0.431、0.339、0.403화0.585,P균＜0.05),여혈청C3정부상관(r=-0.396,P＜0.01).뇨NGAL수평여만성지수정정상관(r=0.719,P＜0.01).②혈청MCP-1랑창신염조(284±1 13) pg/ml고우비랑창신염조(173±69)pg/ml,P＜0.01；뇨MCP-1수평재랑창신염조M=1154、(P75 41 178,P5 341)pg/mg기항고우비랑창신염조M=456、(P75 714,P25 114)pg/mg 기항(P＜0.01).혈청MCP-1수평여정체SLEDAI평분、신외SLEDAI평분、신SLEDAI평분、뇨단백정량(24 h)、혈기항수평균정정상관(r=0.340、0.416、0.385、0.574화0.654,P균＜0.05),여혈청C3수평정부상관(r=-0.458,P＜0.01).뇨MCP-1수평여전신SLEDAI평분、신외SLEDAI평분、신SLEDAI평분、혈청항dsDNA항체、뇨단백정량(24 h)、혈기항수평균정정상관(rs=0.448、0.429、0.459、0.412、0.375화0.419,P균＜0.05).뇨MCP-1수평여만성지수정정상관(r=0.689,P＜0.01).③6례랑창신염뇨중가검측도TWEAK.결론 뇨NGAL화MCP-1수평승고제시신장만성손상.혈NGAL화혈、뇨MCP-1수평재랑창신염활동시균명현승고,가용우감측랑창신염병정활동.TWEAK림상의의수요진일보연구.
Objective To investigate the clinical significance of neutrophil gelatinase-associated lipocalin (NGAL),monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor-like apoptosis weak inducer (TWEAK) level in body fluids of lupus nephritis (LN) patients..Methods Levels of NGAL,MCP-1 and TWEAK in the serum and urine of 51 patients with SLE,including 27 LN cases and 24 non-LN cases,were detected by enzyme-linked immunosorbent assay; and the clinical data were collected.Student's t test,Mann-Whitney U test,Pearson's correlations and Spearman's rank correlations were used for statistical analysis.Results (①) The level of serum NGAL in the LN group (122±70) ng/ml was higher than that in the non-LN group (56 ± 34) ng/ml (P＜0.01).There was a positive correlation (r=0.408,0.431,0.339,0.403 and 0.585,P＜0.05) between the serum NGAL and general SLEDAI score,extra-renal SLEDAI score,renal SLEDAI score,the levels of 24-hour urine protein and serum creatinine.There was a negative correlation (r=-0.396,P＜0.01) between the serum NGAL and serum C3 level.There was a positive correlation (r=0.719,P＜0.01) between urinary NGAL levels and chronic index (CI).② The level of serum MCP-1 in the LN group (284 ± 113) pg/ml was higher than that in the non-LN group (173± 69) pg/ml,(P＜0.01).The level of urinary MCP-1 in the LN group (M=1154,P75 41 178,P25 341) pg/mg creatinine was higher than that in the non-LN group (M=456,P75 714,P~ 114) pg/mg creatinine (P＜0.01).There was a positive correlation (r=0.340,0.416,0.385,0.574 and 0.654,P＜0.05) between the serum MCP-1 level and the overall SLEDAI score,extra-renal SLEDAI score,renal SLEDAI score,24-hour urinary protein excretion level and serum creatinine levels.There was a negative correlation (r=-0.458,P＜0.01) between the serum MCP-1 level and serum C3 levels.There was a positive correlation (rs=0.448,0.429,0.459,0.412,0.375 and 0.419,P＜0.05) between urinary MCP-1 level and total SLEDAI score,extra-renal SLEDAI score,renal SLEDAI score,serum ds-DNA antibodies,24-hour urinary protein excretion level and serum creatinine levels.There was a significant positive correlation (r=0.689,P＜0.01) between urinary MCP-1 levels and CI.(③) TWEAK was detected in the urine of 6 cases of LN.Conclusion The urinary NGAL and MCP-1 levels are elevated in patients with chronic damage,which suggestes chronic renal injury.It can be used to monitor the LN disease activity.The blood levels of NGAL and urine MCP-1 are significantly higher in LN.The clinical significance of TWEAK needs further study.
