狼疮性肾炎患者免疫指标及免疫发病机制模式分析
Analysis of immunity index and immunopathogenesis pattern of lupus nephritis patients.
作者信息
Gao J X, Diao H L, Liu Y Q, Lv M, Dong H, Zhang X M, Wang Y N
机构信息
Department of Nephrology, Binzhou Medical University Hospital, Binzhou, China.
Department of Physiology, Binzhou Medical University, Binzhou, China.
出版信息
J Biol Regul Homeost Agents. 2015 Jan-Mar;29(1):201-6.
Joint detection of anti-dsDNA antibodies, anti-U1RNP, anti-SM antibodies, anti-SSA antibodies, anti-ribosomal P protein antibodies, anti-nucleosome antivodies (Anua), anti-histone antibodies (AHA) and antinuclear antibodies brings to the early diagnosis of systemic lupus erythematosus (SLE) and speculation of renal lesion degree of lupus nephritis patients in order to choose a specific therapeutic schedule. This paper analyzed the abnormal immunology features and connections of each pathological pattern of LN renal biopsy and probed into the essence in order to provide basis for diagnosis, treatment, pathological pattern speculation and forward assessment of LN. We chose 97 cases, treated them with renal biopsy and pathological pattern classification, analyzed pathological pattern distribution, different pathological patterns and the correlation of immunity index with anti-dsDNA antibodies, anti-U1RNP, anti-Sm antibodies, anti-SSA antibodies, anti-ribosomal P protein antibodies, Anua, AHA and ANA of the first renal biopsy were taken as the experiment index. The results showed that the morbidity of the male was distinctly lower than the female and the age of onset was much lower (P < 0.05); pattern I, pattern II, pattern III, pattern IV, pattern V, and pattern VI accounted for 1.0%, 3.1%, 12.4%, 47.4%,16.5%, 15.5%, 4.1%, 0%,respectively; among all the LN patients, there were respectively 59, 43, 28, 52, 51, 48, 36 and 93 cases in which anti-dsDNA antibody, anti-U1RNP antibody, anti-Sm antibody, anti-SSA antibody, anti-ribosomal P protein antibodies, Anua, AHA and ANA had increased and the positive rate was 60.8%, 44.3%, 28.9%, 53.6%, 52.6%, 49.5%, 37.1% and 95.9%, respectively. In conclusion, pattern IV is the most common of all pathological patterns of LN. Among the immunity index, anti- U1RNP antibodies and anti-SSA antibodies are positively correlated with anti-dsDNA antibodies; Anua is positively correlated with anti-dsDNA antibodies and AHA; anti-dsDNA antibodies, anti U1RNP antibodies, anti-Sm antibodies, anti SSA antibodies, AHA, anti-ribosomal P protein antibodies and ANA have no obvious correlation with LN renal lesions degree; Anua level of serum is positively correlated with LN renal lesions degree.
联合检测抗双链DNA抗体、抗U1RNP、抗SM抗体、抗SSA抗体、抗核糖体P蛋白抗体、抗核小体抗体（Anua）、抗组蛋白抗体（AHA）及抗核抗体，有助于系统性红斑狼疮（SLE）的早期诊断及推测狼疮肾炎患者的肾脏病变程度，以便选择具体的治疗方案。本文分析了狼疮性肾炎（LN）肾活检各病理类型的异常免疫学特征及相关性，并探究其本质，为LN的诊断、治疗、病理类型推测及预后评估提供依据。我们选取97例患者，进行肾活检及病理类型分类，分析病理类型分布、不同病理类型及首次肾活检时抗双链DNA抗体、抗U1RNP、抗Sm抗体、抗SSA抗体、抗核糖体P蛋白抗体、Anua、AHA及ANA与免疫指标的相关性，并将其作为实验指标。结果显示，男性发病率明显低于女性，发病年龄也低得多（P<0.05）；Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型、Ⅴ型及Ⅵ型分别占1.0%、3.1%、12.4%、47.4%、16.5%、15.5%、4.1%、0%；在所有LN患者中，抗双链DNA抗体、抗U1RNP抗体、抗Sm抗体、抗SSA抗体、抗核糖体P蛋白抗体、Anua、AHA及ANA升高的分别有59、43、28、52、51、48、36及93例，阳性率分别为60.8%、44.3%、28.9%、53.6%、52.6%、49.5%、37.1%及95.9%。综上所述，Ⅳ型是LN所有病理类型中最常见的。在免疫指标中，抗U1RNP抗体和抗SSA抗体与抗双链DNA抗体呈正相关；Anua与抗双链DNA抗体及AHA呈正相关；抗双链DNA抗体、抗U1RNP抗体、抗Sm抗体、抗SSA抗体、AHA、抗核糖体P蛋白抗体及ANA与LN肾脏病变程度无明显相关性；血清Anua水平与LN肾脏病变程度呈正相关。
Zotero 插件