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目的初步探讨血浆6-酮-前列腺素F1α(6-酮-PGF1α)、8-表氧-前列腺素F2α(8-表氧-PGF2α)和11-去氢-血栓烷B2(DH-TXB2)水平在狼疮肾炎(LN)中的临床意义。方法采用酶联免疫吸附试验(ELISA)和放射免疫法对46例LN患者和20名正常对照进行血浆6-酮-PGF1α、8-表氧-PGF2α和DH-TXB2等检测,分别分析其与系统性红斑狼疮活动指数(SLEDAI)、血清抗dsDNA抗体、补体C3、24h尿蛋白定量及内生肌酐清除率(Ccr)的相关关系,同时观察治疗后上述指标的变化。结果①LN组患者血浆6-酮-PGF1α水平显著低于对照组(P<0.05),且活动期组显著低于非活动期组(P<0.05),而LN组患者血浆8-表氧-PGF2α、DH-TXB2均显著高于对照组,且活动期组均显著高于非活动期组。②经相关分析,血浆6-酮-PGF1α水平与SLEDAI、血清抗dsDNA抗体呈负相关,与C3呈正相关;血浆8-表氧-PGF2α及DH-TXB2均与SLEDAI、血清抗dsDNA抗体呈正相关,与C3、Ccr呈负相关。经综合治疗后,血浆6-酮-PGF1α显著升高,8-表氧-PGF2α及DH-TXB2均显著降低。结论血管内皮损伤、脂质过氧化及血小板活化是LN的发生、发展的重要机制。
Objective To investigate the effects of plasma 6-keto-PGF1α, 8-epi-prostaglandin F2α (8-epi-PGF2α) and 11-dehydro-thromboxane B2 In lupus nephritis (LN) in the clinical significance. Methods The plasma levels of 6-keto-PGF1α, 8-epi-PGF2α and DH-TXB2 in 46 patients with LN and 20 normal controls were detected by enzyme linked immunosorbent assay (ELISA) and radioimmunoassay. SLEDAI, serum anti-dsDNA antibody, complement C3, 24h urinary protein and endogenous creatinine clearance rate (Ccr), and to observe the changes of these indexes after treatment. Results ① The plasma levels of 6-keto-PGF1α in LN group were significantly lower than those in control group (P <0.05), and were significantly lower in active group than those in inactive group (P <0.05) , DH-TXB2 were significantly higher than the control group, and the active group were significantly higher than the inactive group. The level of 6-keto-PGF1α in plasma was negatively correlated with SLEDAI and serum anti-dsDNA antibody and positively correlated with C3. Plasma 8-epi-PGF2α and DH-TXB2 were positively correlated with SLEDAI and serum anti-dsDNA antibody, And C3, Ccr was negatively correlated. After the comprehensive treatment, plasma 6-keto-PGF1α significantly increased, 8-epi-PGF2α and DH-TXB2 were significantly reduced. Conclusion Vascular endothelial injury, lipid peroxidation and platelet activation are important mechanisms of the occurrence and development of LN.