[1]肖广智,高 旋,丁 进.血清补体C3, C4 水平正常的活动性狼疮性肾炎患者的临床特征与实验室相关指标分析[J].现代检验医学杂志,2022,37(05):39-43.[doi:10.3969/j.issn.1671-7414.2022.05.009]
　XIAO Guang-zhi,GAO Xuan,DING Jin.Analysis of Clinical and Laboratory Characteristics of the Patients of Active Lupus Nephritis with Normal Levels of Serum Complement C3 and C4[J].Journal of Modern Laboratory Medicine,2022,37(05):39-43.[doi:10.3969/j.issn.1671-7414.2022.05.009]
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血清补体C3, C4 水平正常的活动性狼疮性肾炎患者的临床特征与实验室相关指标分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年05期
页码:
39-43
栏目:
论著
出版日期:
2022-09-15

文章信息/Info

Title:
Analysis of Clinical and Laboratory Characteristics of the Patients of Active Lupus Nephritis with Normal Levels of Serum Complement C3 and C4
文章编号:
1671-7414（2022）05-039-05
作者:
肖广智; 高 旋; 丁 进
空军军医大学第一附属医院临床免疫科, 西安 710032
Author(s):
XIAO Guang-zhi;  GAO Xuan;  DING Jin
Department of Clinical Immunology, the First Affiliated Hospital of Air Force Medical University, Xi’an 710032, China
关键词:
系统性红斑狼疮; 狼疮性肾炎; 血清补体; 自身抗体
分类号:
R593.242；R446.11
DOI:
10.3969/j.issn.1671-7414.2022.05.009
文献标志码:
A
摘要:
目的　探讨血清补体(complement) C3 和C4 水平正常的活动性狼疮性肾炎(lupus nephritis, LN) 患者的临床及实验室特征。方法　纳入2011 年1 月～ 2019 年11 月在空军军医大学第一附属医院住院的活动性LN 患者210 例，根据血清补体C3 和C4 水平分为血清补体正常组(n=30）和补体降低组（n=180），比较两组患者临床与实验室相关指标的差异。结果　血清补体C3 和C4 水平正常组患者的SLE 疾病活动度评分（systemic lupus erythematosus disease activityindex，SLEDAI）低于补体降低组（8.70±4.79 vs 13.29±4.77）, 差异有统计学意义（t=-4.877, P ＜ 0.001）。血清补体C3 和C4 水平正常组患者的血清清蛋白（32.54±7.68 g/L）、血清总蛋白（60.98±13.14g/L）、血红蛋白（111.43±24.59g/L）和红细胞计数[（3.85±0.74）×1012/L] 水平高于降低组[29.65±6.29 g/L，55.60±11.11g/L，95.96±19.65 g/L，（3.31±0.69）×1012/L]，而血尿酸低于降低组（367.49±158.91μmol/L vs 276.13±82.57μmol/L），差异均有统计学意义（t=2.257，2.394，3.844，3.875，-4.765，均 P ＜ 0.05）。血清补体C3 和C4 正常组患者的抗核小体抗体（16.7%）、抗C1q 抗体（20.0%）和抗双链DNA（dsDNA）抗体（16.7%）的阳性率低于降低组（57.2%，41.7%，55.0%），差异均有统计学意义（χ2=14.272，6.815，15.116，均P ＜ 0.05）。肾脏病理结果提示血清C3 和C4 正常组单纯V 型的LN比例（11/23, 47.8%）高于降低组（13/90, 14.4%），两组间病理分型分布差异有统计学意义（χ2=14.774, P=0.002）。结论　活动性LN中血清补体C3和C4水平正常的患者疾病活动度更低，贫血发生率更低，狼疮特异性自身抗体阳性率更低，V 型LN 的比例更高，可能属于一类特殊亚型。
Abstract:
Objective　To study the clinical and laboratory characteristics of the patients of active lupus nephritis (LN) with normal levels of serum complement C3 and C4. Methods　A total of 210 active LN patients hospitalized in the First Affiliated Hospital of Air Force Military Medical University from January 2011 to November 2019 were selected in the study. The patients were divided into two groups according to serum complement C3 and C4 levels,of which 30 were in normal complement group and 180 in decreased complement group. The differences of clinical and laboratory characteristics between two groups were analyzed. Results　The systemic lupus erythematosus disease activity index (SLEDAI) of LN patients in normal-complement group (8.70 ± 4.79) was lower than that in decreased-complement group (13.29 ± 4.77) with statistically significant (t=-4.728, P＜ 0.001). The levels of serum albumin（32.54±7.68 g/L）, serum total protein（60.98±13.14g/L）, hemoglobin（111.43±24.59 g/L） and red blood cell count[（3.85±0.74）×1012/L] in normal complement group were higher than those in decreasedcomplement group[29.65±6.29 g/L，55.60±11.11g/L，95.96±19.65 g/L，（3.31±0.69）×1012/L], while serum uric acid was lower than that in decreased-complement group（367.49±158.91μmol/L vs 276.13±82.57μmol/L）, the differences were statistically significant（t=2.257，2.394，3.844，3.875，-4.765，all P ＜ 0.05）. The positive percentages of anti-nucleosome （16.7%），anti-C1q（20.0%）and anti-dsDNA （16.7%）antibodies were lower in normal complement group（57.2%， 41.7%，55.0%）, the differences were statistically significant（χ2=14.272, 6.815, 15.116，all P ＜ 0.05）. The results of renal biopsy showed that the proportion of type V LN was higher in normal complement group (11/23, 47.8%) than that in decreasedcomplement group (13/90, 14.4%), and there was a significant difference in the distribution of pathological types between two groups (χ2=14.774, P=0.002). Conclusion　The patients with normal levels of serum complement C3 and C4 in active LN may be a special subtype which had lower disease activity, lower rate of anemia and SLE specific antibodies positivity, and higher percentage of type V LN .

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备注/Memo

备注/Memo:
作者简介：肖广智 (1975-)，男，学士，主治医师，研究方向：自身免疫疾病，E-mail：1020626441@qq.com。
通讯作者：丁进 (1978-)，女，博士，副主任医师，研究方向：自身免疫疾病，E-mail: dingjin@fmmu.edu.cn。
更新日期/Last Update: 2022-09-15