IgA型抗内皮细胞抗体水平与狼疮性肾炎疾病活动程度的关系

摘要

Objective To investigate the relationship between the level of IgA anti-endothelial cell antibodies ( IgA-AECA) and the disease activity of lupus nephritis ( LN) .Methods A total of 120 patients with systemic lupus erythematosus were divided into LN group(n=80) and non-LN group(n=40),meanwhile,50 healthy subjects and 50 patients with other types of nephritis were selected as healthy control group and other nephritis group respectively .The positive expression rates of serum IgA-AECA were compared among the four groups.The LN group was divided into active LN group (n=36) and non-active LN group(n=44) depending on the disease activity of LN.The factors influencing the activity of LN were analyzed ,and the levels of serum IgA-AECA were compared among patients with different LN activity indexes .Results The positive expression rate of IgA-AECA of the LN group or the non-LN group was higher than that in the healthy control group or the other nephritis group(P<0.05),but there was no significant difference between LN group and non-LN group (P>0.05).The expression levels of serum IgA and double-strand DNA antibody,and the positive rates of active histological changes and IgA-AECA were higher while the level of serum C3 was lower in the active LN group compared to the non-active LN group(all P<0.05). Positive IgA-AECA and active histological changes were independent risk factors for active LN (all P<0.05).Significant differences were observed in the serum IgA-AECA level among LN patients with different scores for transparent thrombosis , glomerulus cell proliferation , leukocyte infiltration and fibrosis necrosis or karyorrhexis (all P<0.05).Conclusion IgA-AECA might become an indicator for judging the disease activity of LN .%目的 探讨IgA型抗内皮细胞抗体(IgA-AECA)水平与狼疮性肾炎(LN)疾病活动程度的关系.方法 选取120例系统性红斑狼疮患者分为LN组80例和非LN组40例.选取同期就诊的健康人50例和其他肾炎患者50例分别作为健康对照组及其他肾炎组.比较4组的血清IgA-AECA阳性表达率.根据LN疾病活动程度将LN组分为活动性LN组36例与非活动性LN组44例,分析LN活动性的影响因素,并比较不同疾病活动指数LN患者的IgA-AECA血清水平.结果 LN组、非LN组IgA-AECA阳性表达率均高于健康对照组和其他肾炎组(P<0.05),但LN组与非LN组间比较,差异无统计学意义(P>0.05).活动性LN组血清IgA、双链DNA抗体表达水平及组织活动性病变、IgA-AECA阳性率均高于非活动性LN组,血清C3水平低于非活动性LN组(均P<0.05).IgA-AECA阳性及存在组织活动性病变是LN活动的独立危险因素(均P<0.05).不同透明血栓、肾小球细胞增殖、白细胞浸润以及纤维素样坏死或核破裂评分的LN患者血清IgA-AECA水平比较,差异均有统计学意义(均P<0.05).结论 IgA-AECA或可成为判断LN疾病活动程度的指标.