284例系统性红斑狼疮的遗传因素分析

目的:探讨遗传因素在系统性红斑狼疮(SLE)发病中的作用.方法:采用遗传流行病学病例对照研究方法对284例住院SLE患者进行统计学分析.结果:有家族遗传史和无家族史患者相比,在发病年龄、冠心病、合并其他结缔组织病、特殊用药史以及肾脏损害方面,差异有统计学意义(P<0.05),而高血压,高血脂、糖尿病、肝功能异常、良性或恶性肿瘤,差异无统计学意义(P＞0.05).结论:遗传因素在SLE的发病中起着重要作用.     

女性系统性红斑狼疮患者血清瘦素水平的检测及意义

目的：探讨女性系统性红斑狼疮患者血清瘦素水平的变化。方法：采用放射免疫分析法对54例女性系统性红斑狼疮患者及30例正常对照组血清瘦素水平进行了检测。结果：女性系统性红斑狼疮患者血清瘦素水平明显高于正常对照组，差异有显著性；月经周期正常者、月经周期紊乱者、闭经者血清瘦素水平明显高于正常对照组，差异有显著性；有肾脏损害及无肾脏损害患者血清瘦素水平亦升高，与正常对照组相比，差异有显著性。结论：女性系统性红斑狼疮患者血清瘦素水平的变化可能与系统性红斑狼疮的发病有关。     

女性系统性红斑狼疮患者瘦素、泌乳素及性激素的检测

目的:检测女性系统性红斑狼疮(SLE)患者血清中瘦素、泌乳素及性激素水平并探讨其意义.方法:采用放射免疫分析法对34例女性SLE及30例正常对照组血清瘦素、泌乳素及性激素水平进行了检测.结果:女性SLE患者血清瘦素水平(11.58±1.76)ng/mL明显高于对照组(6.82±1.65)ng/mL,性激素中雌二醇(102.56±28.38)pmol/L明显高于对照组(72.80±25.29)pmol/L,睾酮水平(1.03±0.24)nmol/L明显低于对照组(4.86±1.12)nmol/L.黄体生成素及卵泡刺激素水平与对照组相比,差异无显著性(P＞0.05),而泌乳素水平(32.53±8.51)μg/L高于正常对照组(15.20±3.29)μg/L(P<0.01).相关分析显示瘦素水平与雌二醇和泌乳素水平呈正相关(P<0.05),与睾酮水平呈负相关(P<0.05).结论:女性SLE患者瘦素水平可能与雌二醇、睾酮及泌乳素的变化有关.     

SLE患者血清抗核小体抗体的检测

SLE是一种累及多系统多器官的自身免疫性疾病,主要特征是体内产生多种针对细胞核结构和组分的自身抗体,包括DNA、组蛋白和核小体等的自身抗体,引起组织和器官损伤.目前临床实验室诊断SLE的抗体主要有抗核抗体、抗dsDNA抗体和抗可提取核抗原抗体.     

女性SLE血清性激素及胰岛素样生长因子-1的研究

目的：探讨性激素和胰岛素样生长因子－１（ＩＧＦ－１）在ＳＬＥ发病中的作用。方法．：采用放射免疫法检测２０例女性ＳＬＥ血清酮（Ｔ）、游离睾酮（ＦＴ）、二氢睾酮（ＤＨＴ）、脱氢表雄酮（ＤＨＥＡ）、雌二醇（Ｅ２）、孕酮（Ｐｒ、）泌乳素（ＰＲＬ）和ＩＧＦ－１水平。结果：ＳＬＥ口才血清Ｔ、ＦＴ、ＤＨＴ、ＤＨＥＡ、Ｐｒ明显低于正常ＰＲＬ、ＩＧＦ－１明显高于正常对照,Ｅ２无差异;性激素及ＩＧＦ－１水平与疾病活动     

系统性红斑狼疮患者血管内皮祖细胞测定

目的 探讨系统性红斑狼疮（SLE）患者外周血中血管内皮祖细胞的变化。 方法 IL ACL-9000型血液凝固仪测定82例SLE患者和50例健康对照vW因子抗原含量（vWF:Ag）。流式细胞仪分析外周血中内皮祖细胞（endothelial progenitor cells,EPC）和循环内皮细胞（circulating endothelial cell,CEC）的水平。用线性相关分析检测vWF:Ag、CEC、EPC等指标之间的相关性。 结果 SLE活动期患者外周血每20万个单一核细胞中CD34+细胞、CD133+细胞、CD34+CD133+双阳性细胞数（35.4 ± 16.7、86.5 ± 32.1、361.3 ± 176.4）分别高于稳定期患者（17.1 ± 10.9、28.7 ± 21.5、107.2 ± 44.3）和健康人（13.8 ± 9.6、11.2 ± 5.5、92.3 ± 50.5）,差异均有统计学意义（P值均 < 0.01）。与稳定期患者比较,SLE活动期患者外周血每20万个单一核细胞中EPC数（361.3 ± 176.4）和vWF:Ag水平（438.9 ± 205.3）%增高,差异有统计学意义（P值均 < 0.01）;CEC差异无统计学意义（P > 0.05）。稳定期患者各项指标与对照组间无统计学意义（P值均 > 0.05）。SLE患者活动期EPC与vWF:Ag呈正相关（r = 0.67,P < 0.01）,与CEC无统计学相关性（P > 0.05）。 结论 SLE患者外周血中EPC数量与血管损伤标志物（vWF:Ag）水平密切相关,表明EPC数量改变可以作为评价病情活动的标志物之一。     

Kidney transplantation in patients with systemic lupus erythematosus

Despite improvements in overall prognosis in lupus nephritis, 10%-30% of patients with proliferative renal involvement progress to end stage renal disease, according to the severity of the disease and associated socioeconomic factors. Kidney transplantation has been recognized as the most appropriate treatment for those patients, but several issues remain after renal function restoration in a lupus recipient. Among these are the fear of lupus nephritis recurrence in the graft, the choice of immunosuppressive therapy in cases of recurrent lupus for a patient who has already received a toxic and prolonged immunosuppressive course, and finally, the management of comorbidities to reduce associated morbidities in the long term. All the above topics are examined in this review, with the hope of providing a clear picture of data as illustrated in the current literature.     

Comparison of IgG subclass autoantibodies in patients with systemic lupus erythematosus and subacute cutaneous lupus erythematosus

Circulating antinuclear antibodies and in vivo bound immunoglobulins at the dermal-epidermal junction are frequently seen in patients with lupus erythematosus. The present study was designed to examine the distribution of the IgG subclasses of in vivo skin bound IgG and circulating antinuclear antibodies (ANA) in patients with systemic lupus erythematosus (SLE) or subacute cutaneous lupus erythematosus (SCLE). Immunofluorescence studies on skin biopsies showed IgG1 to be the predominant IgG subclass in SCLE patients, present in 20 of 21 (95%) of the specimens. IgG2 was present in 4 patients (19%), IgG3 in 1 (5%), and IgG4 in 7 (33%). The frequencies of IgG2, IgG3, and IgG4 skin staining were significantly higher in the seven SLE patients who were studied: IgG1 in 7/7 (100%), IgG2 in 7/7 (100%) and IgG4 in 6/7 (86%). Immunoblot analysis for the IgG subclasses was performed on serum of 29 patients with SCLE who had antibodies to SSA/Ro antigen. Twenty-seven (93%) of these patients were positive for IgG1 anti-SSA/Ro antibody, while the frequencies for IgG2, IgG3, and IgG4 anti-SSA/Ro were very low. These studies indicate that there is a difference in the IgG subclass antibody response in patients with SLE and SCLE. The presence of more than one subclass antibody may be indicative of systemic disease.     

Antineutrophil cytoplasmic antibodies in patients with systemic lupus erythematosus

We determined the prevalence of antineutrophil cytoplasmic antibodies (ANCAs) in patients with systemic lupus erythematosus (SLE) and evaluated the correlation between ANCA positivity and clinical features. Forty-one patients with SLE and two control groups were examined. One of the control groups consisted of 15 patients with systemic vasculitis, and the other of 12 healthy blood donors. A quantitative enzyme-linked immunosorbent assay technique was used to measure the serum cytoplasmic ANCA (cANCA) and perinuclear ANCA (pANCA) levels. cANCA positivity was found in three patient samples, and pANCA positivity in 10 SLE patients. The occurrence and titres of both ANCA types in SLE patients were similar to those in healthy controls and significantly lower than those in patients with systemic vasculitis. The clinical picture and antibody profile were similar in ANCA-positive and ANCA-negative SLE patients. We conclude that measurement of ANCAs does not provide any additional diagnostic or prognostic data in SLE.     

Herpes zoster in Japanese patients with systemic lupus erythematosus

We examined retrospectively the incidence of herpes zoster among 58 Japanese patients with systemic lupus erythematosus (SLE), 42 patients with systemic sclerosis (SSc) and 21 patients with autoimmune bullous diseases (AIBD). The incidence of herpes zoster was significantly higher in SLE (46.6%) than in SSc (9.5%) or AIBD (4.7%) (P < 0.001). The rate of positive delayed-type skin test with varicella zoster virus antigens was significantly lower in SLE than in SSc [4/16 (25.0%) vs. 11/12 (91.7%), P < 0.001]. In addition, the positive rate of skin test with purified protein derivatives of tuberculin was also low in SLE patients (3/16, 18.8%). These results reconfirm the general impairment in cellular immunity in SLE.