摘要
目的研究狼疮性肾炎(LN)患者尿液和肾组织中细胞间粘附分子(ICAM-1)和血管粘附分子(VCAM-1)的变化情况,探讨尿s ICAM-1和VCAM-1水平与肾脏活动性病理改变的相关性。方法选取我院收治经肾穿刺活检确诊为LN的患者92例。并同时纳入20例门诊健康体检者做为对照。收集肾穿刺活检当日患者的尿液,Elisa法检测尿液s ICAM-1和VCAM-1水平。免疫组织化学染色法检测肾组织中ICAM-1和VCAM-1的表达情况。ROC曲线分析尿s ICAM-1和VCAM-1在预测活动性LN中的敏感性和特异性。结果与非活动性LN和正常人相比,活动性LN患者尿s ICAM-1和VCAM-1水平显著升高,肾脏ICAM-1和VCAM-1表达也显著增加并与尿s ICAM-1和VCAM-1水平成正相关关系。尿s ICAM-1的ROC曲线分析显示,曲线下面积为0.874,尿s ICAM-1值>1095.00 pg/mg creatinine诊断为活动性LN,特异性94.5%,敏感性78.9%。尿VCAM-1的ROC曲线分析显示,曲线下面积为0.882,尿VCAM-1值>898.11 pg/mg creatinine诊断为活动性LN,特异性98.2%,敏感性66.7%。结论尿s ICAM-1和VCAM-1水平可作为判断LN活动性的生物标志物。检测这两个指标可帮助观察LN患者的病情变化,为个体化治疗提供新依据。
Objective To determine the levels of urinary soluble intercellular adhesion molecule- 1（s ICAM- 1） and vascular cellular adhesion molecule-1（VCAM-1） in patients with lupus nephritis（LN）, and explore their correlation with renal disease activity. Methods Urine samples were collected from 92 renal biopsy- proven LN patients and 20 healthy controls. Renal disease activity was determined according to the ISN/RPS 2003 Revised Classification of Lupus Nephritis. The urine levels of s ICAM-1 and VCAM-1 were detected by enzyme-linked immunosorbent assay, and the expressions of intrarenal ICAM-1 and VCAM- 1 were evaluated by immunohistochemisty staining. Results Urinary s ICAM- 1 and VCAM- 1 levels were elevated in LN patients compared with the controls. Significantly higher levels of urinary s ICAM-1 and VCAM-1 were found in patients with active LN, who had also significantly increased intrarenal expressions of ICAM-1 and VCAM-1 compared with patients in remission. A strong positive correlation was noted between intrarenal expression and urine levels of ICAM-1 and VCAM-1.The receiver- operating characteristic（ROC） curve of urine s ICAM- 1 showed tan area under ROC curve of 0.874 for all participants in the test. A cutoff of 1095.00 pg/mg creatinine yielded a good sensitivity（0.945） and specificity（0.789）. The ROC curve of urine VCAM- 1 showed an area under ROC of 0.882 for all the participants, and a cutoff of 898.11 pg/mg creatinine yielded a good sensitivity（0.982） and specificity（0.667）. Conclusion Urine s ICAM- 1 and VCAM- 1 levels are positively correlated with their intrarenal expressions and reflect the activity of the nephritis, and therefore they may serve as potential biomarkers for early diagnosis of active LN.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2015年第9期1272-1276,1282,共6页
Journal of Southern Medical University
基金
国家自然科学基金(81570619)
国家自然科学基金青年基金(81200502)
广东省优秀博士学位论文作者资助项目(SYBZZXM201322)~~
