摘要
【目的】探讨系统性红斑狼疮肾炎(LN)患者抗中性粒细胞胞浆抗体(ANCA)水平及与其他临床表现的相关性。【方法】选取40例LN患者和23例非LN患者。用间接免疫荧光法(ⅡF)检测患者血清AN-CA(荧光位于胞浆为c-ANCA);位于核周p-ANCA;经典型为a-ANCA;ELISA法检测ANCA抗原(包括抗-MPO,抗-LF,抗-CG)。【结果】40例LN患者中,19例(47.5%)ANCA阳性,其中p-ANCA阳性者17例(89.5%),2例(10.5%)为a-ANCA。无一例出现c-ANCA。在LN组,p-ANCA滴度为(1∶80)(1∶160),滴度最高者为弥漫性增生性肾小球肾炎(DPGN);2例a-ANCA均出现在急进性肾小球肾炎(RPGN)。非LN组23例患者中,仅3例(13%)p-ANCA阳性,滴度为1∶80,且均为抗-MPO。正常对照组无一例ANCA阳性。63例系统性红斑狼疮(SLE)患者中,11例(17.5%)为抗-MPO;10例(15.9%)为抗-LF,且只见于DPGN、局灶增殖性肾小球肾炎(FPGN)和RPGN伴有新月体形成者;8例(12.7%)为抗-CG,但在LN患者未检测到抗-LF及抗-CG。在各种临床表现中,抗-MPO与肾脏和皮肤表现有关;而抗-LF与肾脏、关节炎及浆膜炎有关;抗-CG可见于各种临床表现。【结论】ANCA可能与狼疮肾炎有关,且抗-MPO与其关系最明显。
[Objective]To investigate the prevalence of ANCA in patients with lupus nephritis （LN） and to find the association between ANCA and renal lesion and other clinical manifestations. [Methods]Forty patients with LN and 23 non-LN patients with SLE were studied. Indirect immunofluorescence（ ⅡF） and ELISA were used to detect the ANCA and its target antigen. [Results]In 40 patients with LN, 19 were ANCA positive; among them, 17 were p-ANCA positive,and 2 were a-ANCA positive and all were RPGN, none was c-ANCA positive. Three of 23 non-LN were ANCA positive and all were anti-MPO. There was no ANCA positive in normal control. Among 63 cases with SLE, 11 cases （17.5%） were anti-myeloperoxidase （anti-MPO） ; 10 cases （15.9 % ） were anti-lactoferrin（anti-LF） and seen only in DPGN,FPGN and RPGN with crescents; 8 cases （12.7%） were anti-cathepsin G（anti-CG）. Anti-LF and anti-CG were not detected in non-LN patients. It was observed that anti-MPO was associated with renal and skin manifestation, while anti-LF was seen in renal and joint involvement and serositis. Patients with only anti-CG had a varied clinical presentation. [Conclusion]ANCA ,especially anti-MPO, in SLE may be used as a serological marker along with clinical and histopathological assessment to differentiate vasculitises in LN cases from SLE without nephritis.
出处
《医学临床研究》
CAS
2006年第10期1606-1607,1610,共3页
Journal of Clinical Research
