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目的研究系统性红斑狼疮(systemiclupuserythematosus,SLE)患者血清可溶性标准型CD44(solublestandardformCD44,sCD44std)水平,并探讨其临床意义。方法采用双抗体夹心酶联免疫吸附测定法,检测了28名健康人和67例SLE患者血清sCD44std水平。根据狼疮活动计算标准(lupusactivitycountcriteria,LACC)确定疾病活动组与稳定组,其中活动组49例、稳定组18例,其中16例活动组患者经治疗病情稳定3个月后复查血清,作治疗前后的比较。结果SLE患者血清sCD44std水平明显高于正常对照组(P<0.01),且活动组明显高于稳定组(P<0.01)。血清sCD44std水平在肺病变组、脑病组、肾脏损害组分别显著高于无肺病变组、无脑病组、无肾脏损害组(P均<0.05)。且血清sCD44std水平与24h尿蛋白定量、尿微量白蛋白、尿转铁蛋白、尿IgG呈正相关(P<0.01);与血清IgG、血清IgM呈正相关(P<0.01);与血清C3呈负相关(P<0.01)。16例活动组患者经治疗病情稳定3个月后血清复查,血清sCD44std在治疗稳定后明显下降(P<0.01)。结论血清sCD44std水平与SLE疾病活动性有关,可作为SLE疾病活动和疗效观察的监测指标之一。sCD44std水平升高提示SLE重要脏器(肺、脑、肾)损害的可能;且可作为肾小球损害的早期监测指标之一。
Objective To investigate the serum soluble standard CD44 (sCD44st) levels in patients with systemic lupus erythematosus (SLE) and to investigate its clinical significance. Methods Serum sCD44std levels were measured in 28 healthy people and 67 SLE patients by double antibody sandwich enzyme-linked immunosorbent assay. According to lupus activity count criteria (LACC), the active disease group and the stable group were determined. Among them, 49 cases in the active group and 18 cases in the stable group, of which 16 cases in the active group were treated for 3 months and then the serum was examined, Compare Results The serum levels of sCD44std in SLE patients were significantly higher than those in normal controls (P <0.01), and were significantly higher in active group than those in stable group (P <0.01). Serum sCD44std levels in lung lesion group, encephalopathy group, kidney damage group were significantly higher than those without lung disease group, no encephalopathy group, no renal damage group (all P <0.05). Serum sCD44std levels were positively correlated with serum 24 h urinary protein, urine microalbuminuria, transferrin and urine IgG (P <0.01), serum IgG and serum IgM (P <0.01), but negatively correlated with serum C3 (P <0.01). Serum levels of sCD44std were significantly decreased in the 16 active patients after stable treatment for 3 months (P <0.01). Conclusions Serum sCD44std level is related to the activity of SLE disease and may be used as one of the monitoring indicators for SLE disease activity and curative effect observation. SCD44std levels suggest the possibility of SLE important organs (lung, brain, kidney) damage; and can be used as one of the early indicators of glomerular damage.