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目的 研究狼疮肾炎患者血清sFas和sFasL的变化及意义。方法 采用双抗体夹心酶联免疫吸附法 (ELISA)检测正常对照 18例和狼疮肾炎患者 45例血清sFas和sFasL水平。结果 狼疮肾炎患者sFas和sFasL水平分别为 (14± 7) μg/L和 (0 0 7± 0 0 4) μg/L ,与正常对照组 (2 9±1 2 ) μg/L和 (0 0 5± 0 0 1) μg/L相比 ,差异有高度显著性意义 (P <0 0 1)。活动期sFas水平较缓解期明显增高 ,分别是 (17± 7) μg/L和 (9± 4) μg/L ,P <0 0 1;但sFasL活动期与缓解期差异无显著意义。狼疮肾炎血清sFas水平在白细胞减少、贫血、大量蛋白尿、肾功能减退、补体降低、ANA和抗RNP Ab阳性时升高 ;而sFasL仅在肾功能异常时减低 ,与其他指标没有明显相关性。结论 sFas及sFasL参与了狼疮肾炎的发生 ,sFas可作为狼疮肾炎的活动性实验室指标。
Objective To study the changes and significance of serum sFas and sFasL in patients with lupus nephritis. Methods Serum levels of sFas and sFasL in 18 normal controls and 45 patients with lupus nephritis were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). Results The levels of sFas and sFasL in lupus nephritis patients were (14 ± 7) μg / L and (0 0 7 ± 0 0 4) μg / L respectively, which were significantly higher than those in the normal controls (29 ± 12 μg / L and 5 ± 0 0 1) μg / L, the difference was highly significant (P <0.01). The activity of sFas was significantly higher than that of remission (17 ± 7) μg / L and (9 ± 4) μg / L, respectively, P <0.01; however, there was no significant difference between active and remission stages of sFasL. Serum sFas levels in lupus nephritis increased in leukopenia, anemia, massive proteinuria, impaired renal function, decreased complement, elevated ANA and anti-RNP Ab levels, whereas sFasL decreased only in patients with renal dysfunction and was not significantly associated with other markers. Conclusion sFas and sFasL are involved in the pathogenesis of lupus nephritis. SFas can be used as an active laboratory marker for lupus nephritis.