血清抗C1q抗体与狼疮肾炎病理分型及活动性的相关性

目的研究血清抗C1q抗体水平与狼疮肾炎（lupus nephritis,LN）病理类型及活动性的相关性。方法酶联免疫吸附法（enzyme-linked immunosorbent assay,ELISA）检测47例系统性红斑狼疮（systemlupus erythematosus,SLE）患者（狼疮肾炎37例,非狼疮肾炎10例）血清抗C1q抗体水平,并与狼疮肾炎病理类型及活动性指标进行相关性分析。结果 SLE患者血清抗C1q抗体水平（92±55）U/ml,较正常对照组显著升高;LN患者（99±56）U/ml高于非LN患者（64±53）U/ml（t=3.185,P〈0.01）。各肾脏病理类型的血清抗C1q抗体水平有统计学差异,IV型LN患者（126±48）U/ml,高于其他各LN病理分型（P〈0.01）。血清抗C1q抗体水平与肾脏病理病变活动指数呈正相关（r=0.750,P〈0.01）。肾炎复发组血清抗C1q抗体水平（131±54）U/ml在各临床活动度分组中最高（P〈0.01）。结论血清抗C1q抗体水平与SLE患者肾脏损害显著相关,监测其变化可为临床评估治疗提供重要依据。

Correlation between Serum Anti-C1q Antibodies and Renal Pathohistology and Lupus Nephritis Activity

Objective To analyze the correlation of serum anti-C1q antibody level with renal pathological characteristic and nephritis activity in patients with lupus nephritis （LN）. Methods Serum anti-C1q antibodies were examined by enzyme-linked immunosorbant assay （ELISA） in 47 patients with system lupus erythematosus （SLE） including 37 LN patients and 10 non-LN patients. The correlation between anti-C1q antibody level and renal pathohistology and lupus nephritis activity were analyzed. Results Serum level of anti-C1q antibody in SLE patients [（92±55） U/ml] was significantly higher than that of control groups, and higher in LN patients [（99±56） U/ml] than non-LN patients [（64±53） U/ml] （P0.01）. The serum levels of anti-C1q antibody of each renal pathohistology class were significantly different, and of class IV was the highest [（126±48） U/ml, P0.01]. The serum level of anti-C1q antibody was positively correlated with activity index of renal pathohistology （r=0.750,P0.01）.The serum level of anti-C1q antibody of nephritic flare group [（131±54） U/ml] was highest in all clinical activity classes. Conclusion The serum level of anti-C1q antibody are significantly correlated with renal lesion. Measurement of the antibody may contribute to the evaluation and therapy of LN.