血管性血友病因子及P-选择素对狼疮肾炎患者疾病严重程度的评估作用研究

摘要

Objective To explore the value of von Willebrand Factor ( vWF ) and P - selectin in assessing severity of illness in lupus nephritis patients. Methods The level of vWF and P - selectin in 46 cases of lupus nephritis were determined. Disease activity index, renal histological activity index, and disease chronicity index were compared between the study group ( lupus nephritis patients ) and the control group ( 10 cases of health checkups ) . Results There were 5 cases of type Ⅱ lupus nephritis, 12 cases of type Ⅲ , 20 cases of type Ⅳ , and 9 cases of type V. Patients of type Ⅳ lupus nephritis had the highest disease activity index, renal histological activity index, and disease chronic index, while type Ⅱ had the lowest. The expression of vWF and P - selectin in type Ⅳ and V lupus nephritis patients were higher than that of type Ⅱ and type Ⅲ ( P < 0. 05 ) and that of the control group ( P <0. 05 ). Correlation analysis showed that vWF was positively correlated with renal histological activity index, and nearly correlated with disease activity index. P - selectin was positively correlated with disease activity index, renal histological activity index, and disease chronicity index. Conclusion The expression of vWF and P - selectin indicates disease activity and severity in lupus nephritis patients, therefore can be used as a marker to guide clinical therapy.%目的 研究血管性血友病因子(vWF)及P-选择素对狼疮肾炎患者疾病严重程度的评估作用.方法 检测我院46例狼疮肾炎患者vWF及P-选择素水平,测量疾病活动指数(SLEDAI)、肾组织活动指数、疾病慢性指数,并与健康体检者进行对比分析.结果 纳入狼疮肾炎患者Ⅱ型5例,Ⅲ型12例,Ⅳ型20例,Ⅴ型9例.不同分型的狼疮肾炎患者SLEDAI评分、肾组织活动指数均以Ⅳ型最高,Ⅱ型最低.vWF、P-选择素在Ⅳ及Ⅴ型狼疮肾炎患者中表达水平最高,且与其他两组患者相比差异有统计学意义(P＜0.05).Ⅳ及Ⅴ型患者的vWF及P-选择素水平与对照组比较差异有统计学意义(P＜0.05).相关分析显示vWF与肾组织活动指数呈正相关,与SLEDAI接近相关.P-选择素与肾组织活动指数、疾病慢性指数、SLEDAI呈正相关.结论 vWF及P-选择素提示了狼疮肾炎患者疾病活动性及病变程度,可作为狼疮肾炎患者临床检测指标以指导临床治疗.