目的:探讨抗C1q抗体在系统性红斑狼疮(SLE)及狼疮肾炎(LN)诊断和病情活动性判断中的价值.方法:采用ELISA对SLE患者(n=102)、疾病对照组(n=60)和正常对照组(n=40)外周血血清中抗C1q抗体进行检测.102例SLE分为疾病活动组(60例)和疾病稳定组(42例),并按LN判定标准分为LN组(50例)和非LN组(52例).比较各组抗C1q抗体的阳性率和水平,并与SLE患者实验室指标、活动性评分进行相关分析.结果:抗C1q抗体的阳性率在SLE患者中为64.7％,显著高于疾病对照组和正常对照组患者(均P＜0.05).在SLE活动组,抗C1q抗体阳性率显著高于SLE稳定组(P＜0.01).LN组患者的血清抗C1q抗体的水平及阳性率显著高于非LN组的SLE患者(P＜0.01).相关分析表明,血清中抗C1q抗体水平分别与SLEDAI评分、抗dsDNA抗体水平、GLO、IgG、ESR、CRP和24h尿蛋白定量呈显著正相关,但与白细胞、补体C3、C4、白蛋白含量分别呈显著负相关.结论:抗C1q抗体检测对SLE及LN的诊断和疾病活动性判断有重要价值.检测抗C1q抗体的水平有助于早期发现病情活动,为判断病情和制定治疗策略提供更好的依据.%Objective: To explore the significance of anti-Clq antibodies in diagnosis of systemic lupus erythematosus(SLE) with lupus flare and lupus nephritis(LN). Methods: By using ELISA, serum anti-Clq antibodies were detected from 102 SLE patients, 60 patients suffered with other rheumatic disease,and 40 healthy cases. Then 102 SLE patients were divided into active group including 60 patients and stable groups including 42 patients,LN group including 50 patients and non LN groups including 52 patients on the basis of LN diagnostic criteria.The positive rate and level of anti-Clq antibodies were detected, then to analyze the correlation between the level of anti-Clq antibodies and the results of laboratory detection for SLE patients. Results: The positive rate of anti-Clq antibodies in SLE patients was 64.7%, significantly higher than those in other control groups (P<0.05). The positive rate of anti-Clq antibodies in patients with active SLE was significantly higher than those in patients with inactive SLE(P<0.01). Both the positive rate(P<0.01) and serum levels of anti-Clq (P<0.01) in group LN were significantly higher than those in group non LN. Serum level of anti-Clq antibodies showed a strongly positive correlation with SLEDAI score, anti-dsDNA antibodies, GLO, lgG, ESR, CRP and proteinuria and a negative correlation with WBC,C3,C4 and ALB. Conclusion: Anti-Clq antibodies are associated with SLE,LN and assessment of disease activity. It can not only reflect disease activity ,but also act as a useful marker to diagnose patient condition and treatment efficacy.
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