论文部分内容阅读
目的研究C1q抗体与系统性红斑狼疮(SLE)病情活动和脏器损害的相关性,探讨C1q抗体对SLE疗效及预后的影响。方法用酶联免疫吸附试验(ELISA)检测86例活动期SLE患者血清中的C1q抗体,并对全部病例进行随访,以尿蛋白转阴性和病情初步缓解为随访终点,每半个月进行1次终点的评估。结果56例(65%)SLE患者血清C1q抗体阳性,抗体水平(83±39)U/ml;血清C1q抗体浓度与SLEDAI评分、尿蛋白含量以及抗dsDNA抗体滴度呈正相关(P<0.001),与补体C3、C4水平呈负相关(P<0.001);C1q抗体(+)组患者的肾损害发生率明显高于C1q抗体(-)组(P<0.001);C1q抗体浓度和补体C3是影响SLE疗效的独立因素[相关危险度(RR值)0.99,95%可信区间(CI)0.98~0.997,P=0.010和RR值3.18,95%CI1.05~9.65,P=0.041];C1q抗体(+)与C1q抗体(-)的狼疮肾炎患者尿蛋白转阴的时间经Log-rank检验差异有显著性(字2=4.10,P=0.0428)。结论C1q抗体与SLE的发生、发展密切相关。C1q抗体不仅反映SLE病情的活动性,而且对判断脏器损害情况、评价疗效及预后均有重要意义。
Objective To study the relationship between C1q antibody and systemic lupus erythematosus (SLE) and organ damage, and explore the effect of C1q antibody on the efficacy and prognosis of SLE. Methods Serum C1q antibody was detected by enzyme-linked immunosorbent assay (ELISA) in 86 patients with active SLE and all patients were followed up. Urinary protein negative conversion and initial remission were used as the end point of follow-up, once every two weeks End point assessment. Results The serum level of C1q antibody was positive (83 ± 39) U / ml in 56 cases (65%) of SLE patients. The level of serum C1q antibody was positively correlated with SLEDAI score, urinary protein level and anti-dsDNA antibody titer (P <0.001). The incidence of renal damage in patients with C1q antibody (+) was significantly higher than that of patients with C1q antibody (-) (P <0.001). The concentrations of C1q antibody and complement C3 were also affected The independent factors of SLE efficacy were 0.99, 95% confidence interval (CI) 0.98 to 0.997, P = 0.010 and RR 3.18, 95% CI 1.05 to 9.65, P = 0.041] There was significant difference between the positive (+) and C1q antibody (-) urinary protein in patients with lupus nephritis by Log-rank test (word 2 = 4.10, P = 0.0428). Conclusion C1q antibody is closely related to the occurrence and development of SLE. C1q antibody not only reflect the activity of SLE disease, but also to judge organ damage, evaluate the efficacy and prognosis are of great significance.