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抗双链 DNA 定量水平与系统性红斑狼疮患者蛋白尿严重程度的相关性。

Correlation Between Quantitative Anti-dsDNA Levels with Severity of Proteinuria in Systemic Lupus Erythematosus Patients.

机构信息

Department of Rheumatology, Fatima Memorial Hospital, Lahore, Pakistan; Department of Internal Medicine, KEMU, Mayo Hospital, Lahore, Pakistan.

Department of Rheumatology, Fatima Memorial Hospital, Lahore, Pakistan; Department of Internal Medicine, KEMU, Mayo Hospital, Lahore, Pakistan.

出版信息

Reumatol Clin (Engl Ed). 2022 Oct;18(8):464-468. doi: 10.1016/j.reumae.2021.06.005.

Abstract

OBJECTIVE

To evaluate the correlation of quantitative anti-dsDNA level with proteinuria levels in patients with lupus nephritis in a tertiary care hospital.

STUDY DESIGN

In this prospective cross-sectional study, 76 patients of newly diagnosed SLE coming to Fatima Memorial Hospital were included in the study period between January 2020 to June 2020. Demographic data such as age, gender, lupus manifestations such as serositis, arthritis, mucocutaneous disease, and neuropsychiatric manifestations were recorded. Quantitative anti-dsDNA was measured by enzyme-linked immunosorbent assay and proteinuria was estimated by 24h urinary protein collection. Data was analyzed by SPSS 23. Association between categorical variables was assessed using chi-square test. For comparison of categorical independent and continuous dependent variable t-test or Mann-Whitney U test was applied.

RESULTS

The median age of the cohort was 29 (with inter quartile range - IQR - of 13) years. The female gender comprised of 68 (89.4%) of the cohort population. The median anti-dsDNA level was 54.9 (183.6 IQR) IU, and baseline proteinuria of the cohort was 520mg/dL (1.49 IQR). There was a significant association of anti-dsDNA level with systemic features such as arthritis (p=<0.01), serositis (p=<0.01) and, Raynaud's phenomenon (p=<0.01). NPSLE and mucocutaneous features did not show statistically significant association (p=0.91 and 0.14 respectively). Baseline anti-dsDNA showed a statistically significant correlation with baseline proteinuria levels (p=<0.01).

CONCLUSION

Quantitative anti-dsDNA is directly correlated with nephritis measured as proteinuria, and can be detected even before organ involvement. Hence, it can determine disease course and guide early treatment.

摘要

目的

在一家三级护理医院评估狼疮肾炎患者定量抗 dsDNA 水平与蛋白尿水平的相关性。

研究设计

在这项前瞻性横断面研究中,纳入了 2020 年 1 月至 2020 年 6 月期间在法蒂玛纪念医院新诊断为 SLE 的 76 例患者。记录了人口统计学数据,如年龄、性别、狼疮表现,如浆膜炎、关节炎、黏膜皮肤疾病和神经精神表现;通过酶联免疫吸附试验测量定量抗 dsDNA,通过 24 小时尿液蛋白收集估计蛋白尿。使用 SPSS 23 分析数据。使用卡方检验评估分类变量之间的关联。对于分类自变量和连续因变量的比较,应用 t 检验或 Mann-Whitney U 检验。

结果

队列的中位数年龄为 29 岁(四分位距 IQR-为 13 岁)。女性占队列人口的 68 人(89.4%)。中位抗 dsDNA 水平为 54.9IU(183.6 IQR),队列的基线蛋白尿为 520mg/dL(1.49 IQR)。抗 dsDNA 水平与关节炎(p=<0.01)、浆膜炎(p=<0.01)和雷诺现象(p=<0.01)等系统性特征有显著关联。NPSLE 和黏膜皮肤特征与抗 dsDNA 水平无统计学显著关联(p=0.91 和 0.14 分别)。基线抗 dsDNA 与基线蛋白尿水平呈统计学显著相关性(p=<0.01)。

结论

定量抗 dsDNA 与蛋白尿所测肾炎直接相关,甚至在器官受累之前就可以检测到。因此,它可以确定疾病过程并指导早期治疗。

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