SLE患者血清、尿液和肾脏骨桥蛋白的检测及临床意义

目的 探讨骨桥蛋白(OPN)在SLE患者血清、尿液中的含量及与SLE脏器损害、活动性指标的关系.方法 收集100例SLE患者临床资料,ELISA方法检测OPN在100例SLE患者和30例正常人对照外周血清中的浓度,同时用ELISA检测OPN在57例SLE患者和15例正常人对照尿液中的浓度.免疫组化检测3例SLE患者肾脏组织中OPN蛋白的表达.结果 OPN在SLE患者血清和尿液中浓度显著升高,分别为(64.03±72.87)μg/L和(454.87±231.63)μg/L,与正常对照组(29.88±11.28)μg/L,(122.67±39.47)μg/L]相比,差异有统计学意义(P<0.05), SLE活动组血清和尿液中OPN浓度显著升高,分别为(80.92±87.49)μg/L和(584.36±207.15)μg/L,与SLE非活动组(36.43±23.48)μg/L,(281.08±131.92)μg/L]相比,差异有统计学意义(P<0.05).血清和尿液中OPN浓度均和SLEDAI积分呈正相关(r=0.462,0.901,P值均<0.01).尿液OPN浓度和尿免疫球蛋白G、尿微量白蛋白、尿α1微球蛋白、尿B2微球蛋白呈正相关(r=0.458,0.359,0.342,0.409,P值均<0.05).OPN在狼疮性肾炎患者肾小管上皮表达.结论 OPN与SLE及肾损有密切关系.

Detection of osteopontin in sera,urine and renal tissue in patients with systemic lupus erythematosus and its significance

Objective To investigate the expression of osteopontin (OPN)in serum,urine and renal tissue of patients with systemic lupus erythematosus (SLE)and its relevance with organ damage in and activity of this disease.Methods Enzyme-linked immunoabsorbent assay(ELISA)was applied to detect the concentration of OPN in the sera of 100 patients with SLE and 30 sex-and age-matched normal human controls as well as in the urine of 57 patients with SLE and 15 normal human controls.Renal tissue was obtained from 3 patients with lupus nephritis and subjected to immunohistochemistry for the observation of OPN.Results The level of OPN was significantly higher in the sera and urine of patients with SLE than in those of normal human controls (64.03 ±72.87 μg/L vs 29.88±1 1.28μg/L,454.87±231.63 μg/L vs 122.67±39.47μg/L,both P<0.05).Increased level of OPN in sera and urine was also observed in patients with active SLE com-pared with those with inactive SLE (80.92±87.49μg/L vs 36.43±23.48μg/L,584.36±207.15 μs/L vs 28 1.08±1 3 1.92μg/L,both P<0.05).A positive correlation was noted between the serum level of OPN and SLE disease activity index(SLEDAI)(r=0.462,P<0.01),and the level of urine OPN was positively correlated with both SLEDAI and the concentration of urine immunoglobulin G.urine mierualbumin.urine α1-microglo-bulin,urine β2-microglobulin(r=0.901,0.458,0.359,0.342,0.409,respectively,all P<0.05).OPN was found in renal tubule epithelia of the three patients with lupus nephritis.Conclusion OPN may be involved in the pathogenesis of SLE and associated with the renal damage in patients with lupus nephritis.