CAJ | 학술논문

目的探讨膜攻击复合物(MAC)和H因子在LN中的临床意义.方法应用ELISA检测30例LN患者与25名健康对照组血清中MAC和H因子的浓度,并分析比较其在LN患者血清中的变化及相关实验室指标的关系.采用t检验、x2检验和Spearman相关性分析进行统计学分析.结果 ①LN患者血清MAC的浓度高于健康对照组[(74± 100) μg/ml与(18±8)μg/ml,Z=2.777,P＜0.05];活动组MAC浓度高于非活动组[(92±53) μg/ml与(32±23) μg/ml,t=3.661,P＜0.05];②LN患者血清H因子的浓度低于健康对照组[(311±146) ng/ml与(412±76) ng/ml,Z=-3.139,P＜0.05];活动组H因子低于非活动组[(282±11) ng/ml与(330±20) ng/ml,t=-8.333,P＜0.05];③LN患者血清MAC水平与补体C3呈负相关(r=-0.603,P＜0.05),与抗dsDNA抗体、尿蛋白定量(24 h)、英国SLE评估小组(BILAG)积分、SLEDAI积分呈正相关(r值分别为0.481,0.694,0.709,0.613,P均＜0.05);④LN患者血清H因子水平与补体C3呈正相关(r=0.568,P＜0.05),与抗dsDNA抗体、尿蛋白定量(24 h)、BILAG积分、SLEDAI积分呈负相关(r值分别为-0.443,-0.485,-0.639,-0.597,P均＜0.05).⑤LN患者活动组18例肾活检肾脏病理结果病变以肾小管上皮细胞变性及肾小球细胞增生为主;非活动组11例肾活检病理结果病变以系膜细胞增生为主.结论血清MAC升高、H因子减少通过补体经典途径、旁路途径加速LN的发展,同时与LN全身活动性及肾脏病理改变密切相关,可作为生物标志物反映LN活动性,也对肾脏病理活动性病变的生物学诊断价值提供了新的线索.
목적 탐토막공격복합물(MAC)화H인자재LN중적림상의의.방법 응용ELISA검측30례LN환자여25명건강대조조혈청중MAC화H인자적농도,병분석비교기재LN환자혈청중적변화급상관실험실지표적관계.채용t검험、x2검험화Spearman상관성분석진행통계학분석.결과 ①LN환자혈청MAC적농도고우건강대조조[(74± 100) μg/ml여(18±8)μg/ml,Z=2.777,P＜0.05];활동조MAC농도고우비활동조[(92±53) μg/ml여(32±23) μg/ml,t=3.661,P＜0.05];②LN환자혈청H인자적농도저우건강대조조[(311±146) ng/ml여(412±76) ng/ml,Z=-3.139,P＜0.05];활동조H인자저우비활동조[(282±11) ng/ml여(330±20) ng/ml,t=-8.333,P＜0.05];③LN환자혈청MAC수평여보체C3정부상관(r=-0.603,P＜0.05),여항dsDNA항체、뇨단백정량(24 h)、영국SLE평고소조(BILAG)적분、SLEDAI적분정정상관(r치분별위0.481,0.694,0.709,0.613,P균＜0.05);④LN환자혈청H인자수평여보체C3정정상관(r=0.568,P＜0.05),여항dsDNA항체、뇨단백정량(24 h)、BILAG적분、SLEDAI적분정부상관(r치분별위-0.443,-0.485,-0.639,-0.597,P균＜0.05).⑤LN환자활동조18례신활검신장병리결과병변이신소관상피세포변성급신소구세포증생위주;비활동조11례신활검병리결과병변이계막세포증생위주.결론 혈청MAC승고、H인자감소통과보체경전도경、방로도경가속LN적발전,동시여LN전신활동성급신장병리개변밀절상관,가작위생물표지물반영LN활동성,야대신장병리활동성병변적생물학진단개치제공료신적선색.
Objective To discuss the clinical significance of serum membrane attack complex (MAC)and complete factor H (CFH) level in lupus nephritis (LN).Methods Indirect enzyme-linked immunosorbent assay was used to detect MAC and CFH respectively in 30 LN patients and 25 healthy controls.At the same time other laboratory indexes were detected and the relation between the change of serum MAC and CFH levels and other indexes were analyzed.The data were analyzed by t test,Chi-square test and Spearman correlation analysis.Results The level of serum MAC in LN group was significantly higher than that in healthy controls and non-active group [(74±100)] vs (18±8) μg/ml,Z=2.777,P＜0.05;(92±53) μg/ml vs (32±23) μg/ml,t=3.661,P＜0.05].The level of serum CFH in the LN group was lower than that in healthy controls and non-active group [(311±146) ng/ml vs (412±76) ng/ml,Z=-3.139,P＜0.05;(282±11) ng/ml vs (330±20) ng/ml,t=-8.333,P＜0.05].The serum levels of MAC in the LN group showed negative correlation with the level of C3 (r=-0.603,P＜0.05),and showed positive correlation with dsDNA,24 hours urine protein quantification,as well as the scores of SLEDAI and BILAG (rdsDNA=0.481,P＜0.05;r24 hpro=0.694,P＜0.05;rBILAG=0.709,P＜0.05;rSLEDAI=0.613,P＜0.05).The levels of serum CFH in LN group was positively correlated with the level of C3 (r=0.568,P＜0.05),while negatively correlated with dsDNA,24 hours urine protein quantification,as well as the scores of SLEDAI and BILAG (rdsDNA=-0.443,P＜0.05;r24hpro=-0.485,P＜0.05,rBILAG=-0.639,P＜0.05,rSLEDAI=-0.597,P＜0.05).The pathology of lupus nephritis in the active group of 18 patients showed proliferation of glomerular cells and degenerated tubular epithelial cells,and those in the non-active group was mainly the proliferation of mesangial cells.Conclusion In summary,the increase of MAC and decrease CFH level accelerates the development of lupus nephritis,while they are positively correlated with the change of pathology in active lupus nephritis,and it would be good indirect serological markers for lupus nephritis.