Department of Rheumatology and Immunology, First Affiliated Hospital of Xi'an Jiaotong University, Yanta West Road No. 277, Xi'an, Shaanxi, China.
Clin Biochem. 2021 Mar;89:38-43. doi: 10.1016/j.clinbiochem.2020.12.004. Epub 2020 Dec 9.
To investigate the clinical significance of perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) in patients with systemic lupus erythematosus (SLE).
This retrospective study included 120 SLE patients. All patients were divided into group p-ANCA+ and group p-ANCA-. Demographic characteristics, clinical symptoms, autoantibodies, laboratory tests and renal pathology were compared between these two groups.
Among 120 patients, 45 (37.5%) patients were p-ANCA+ and 75 (62.5%) patients were p-ANCA-. The occurrence of lupus nephritis was significantly higher in group p-ANCA+ (P = 0.046). For autoantibodies, the occurrences of anti-dsDNA, anti-nucleosome and anti-histone were significantly higher in group p-ANCA+ (P < 0.001, P = 0.004 and P = 0.006, respectively). Titers of anti-dsDNA antibody, erythrocyte sedimentation rate (ESR), serum beta-2-microglobulin (β2-MG) and systemic lupus erythematosus disease activity index (SLEDAI) were higher in group p-ANCA+ (P < 0.001, P = 0.021, P < 0.001 and P = 0.005, respectively), while albumin was significantly lower than p-ANCA- group (P = 0.012). There were no differences in the classification of lupus nephritis, activity index and chronicity index. p-ANCA correlated with lupus nephritis, anti-dsDNA antibody, anti-nucleosome antibody and anti-histone antibody, and also disease activity markers, such as titers of anti-dsDNA antibody, ESR, albumin, serum β2-MG and SLEDAI.
The appearance of p-ANCA in SLE indicated high probability of lupus nephritis and more severe condition.
探讨抗中性粒细胞胞浆抗体（p-ANCA）在系统性红斑狼疮（SLE）患者中的临床意义。
本回顾性研究纳入了 120 例 SLE 患者。所有患者分为 p-ANCA+组和 p-ANCA-组。比较两组患者的人口统计学特征、临床症状、自身抗体、实验室检查和肾脏病理。
120 例患者中，45 例（37.5%）为 p-ANCA+，75 例（62.5%）为 p-ANCA-。p-ANCA+组狼疮肾炎的发生率明显更高（P=0.046）。在自身抗体方面，p-ANCA+组抗双链 DNA 抗体、抗核小体抗体和抗组蛋白抗体的发生率明显更高（P<0.001、P=0.004 和 P=0.006）。p-ANCA+组抗双链 DNA 抗体滴度、红细胞沉降率（ESR）、血清β2-微球蛋白（β2-MG）和系统性红斑狼疮疾病活动指数（SLEDAI）均较高（P<0.001、P=0.021、P<0.001 和 P=0.005），而白蛋白明显低于 p-ANCA-组（P=0.012）。狼疮肾炎的分类、活动指数和慢性指数两组间无差异。p-ANCA 与狼疮肾炎、抗双链 DNA 抗体、抗核小体抗体和抗组蛋白抗体以及抗双链 DNA 抗体滴度、ESR、白蛋白、血清β2-MG 和 SLEDAI 等疾病活动标志物相关。
SLE 中 p-ANCA 的出现表明狼疮肾炎的可能性较高，且病情更严重。
