系统性红斑狼疮患者血清中sCD23检测及其临床意义

本文对38例系统性红斑狼疮(SLE)患者血清可溶性CD23(sCD23)含量进行检测，旨在探讨sCD23在SLE发病中的作用及其变化规律。     

血清可溶性晚期糖基化终产物受体水平与系统性红斑狼疮疾病活动度的相关性

目的探讨可溶性晚期糖基化终产物受体(soluble receptor for advanced glycation end-products,sRAGE)在系统性红斑狼疮(systemic lupus erythematosus,SLE)疾病活动度评价中的价值。方法收集2013年6月至2014年6月郑州大学第一附属医院SLE患者的临床及流行病学资料,观察血清sRAGE浓度与SLE疾病活动度的相关性。结果 SLE组、非活动SLE组、活动SLE组和健康对照组sRAGE浓度分别为(1 060.16±762.59)、(912.06±759.98)、(1 232.96±736.16)、(1 300.42±466.01)pgml;SLE组与健康对照组sRAGE浓度差异有统计学意义(Z=-2.891,P=0.004),非活动SLE组、活动SLE组与健康对照组sRAGE浓度差异有统计学意义(χ2=17.999,P=0.000)。血清sRAGE浓度在SLE疾病活动指数≥10(Z=-3.052,P=0.002)和抗双链-DNA抗体滴度≥100(Z=-2.276,P=0.023)者中更高。血清sRAGE浓度与SLE疾病活动指数≥10(r=0.373,P=0.000)呈正相关。结论通过检测血清sRAGE浓度能够评价SLE患者疾病活动度,为制定临床治疗方案提供依据。     

系统性红斑狼疮

系统性红斑狼疮（SLE）是自身免疫性疾病，可累及多个系统及器官。免疫学检查对SLE的诊断、治疗及判断预后有重要指导意义。     

系统性红斑狼疮血清催乳素水平与病情活动的关系

系统性红斑狼疮血清催乳素水平与病情活动的关系林玲黄子扬吴佑星施亚雄催乳素（Ｐｒｏｌａｃｔｉｎ，ＰＲＬ）还具有重要的免疫调节功能，并与系统性红斑狼疮（ＳＬＥ）的发病及其活动性相关。我们连续测定了６５例ＳＬＥ病人血清的ＰＲＬ水平，并与同期其他风湿病患者和...     

维生素D缺乏与系统性红斑狼疮的相关性研究

目的 探讨系统性红斑狼疮（SLE）患者维生素D缺乏现象与疾病活动性的相关性.方法 选取60例SLE患者及30例健康志愿者,收集研究对象临床资料;ELISA法检测血清25-羟基维生素D[25-（OH）D]水平;采用Pearson相关分析法分析血清25-（OH）D水平与SLE疾病活动指数（SLEDAI）、抗ds-DNA抗体滴度、补体C3、补体C4、尿蛋白定量、血清免疫球蛋白G（IgG）的相关性.结果 （1）SLE患者血清25-（OH）D水平[36.8（23.4,53.2）nmol/L]较健康志愿者[58.8（51.1,65.3） nmol/L]明显降低（P＜0.01）;（2）SLE患者中维生素D缺乏比例为53.3％,严重维生素D缺乏比例为15.0％,健康志愿者中维生素D缺乏比例为23.3％,严重维生素D缺乏比例为6.7％,两组比较差异具有统计学意义（P＜0.01）.（3）SLE患者血清25-（OH）D水平与SLEDAI（r=-0.35,P＜0.05）及抗ds-DNA抗体滴度（r=-0.42,P＜0.05）呈负相关,与补体C3（r=0.25,P＜0.05）、补体C4（r=0.28,P＜0.05）呈正相关,与尿蛋白定量、血清IgG水平无明显相关性（P＞0.05）.结论 SLE患者中维生素D缺乏现象普遍存在,血清维生素D水平与疾病活动性具有一定相关性.     

系统性红斑狼疮与银屑病并存一例

系统性红斑狼疮(SLE)是一种累及全身多个系统的自身免疫性疾病，银屑病是一种常见的原因不明的慢性皮肤病，这两种疾病出现在同一患者并不多见．我们收治了1例SLE合并寻常型银屑病的病例，现报告如下。     

系统性红斑狼疮免疫机制研究进展

系统性红斑狼疮（systemic lupus erythematosus，SEE）是一种累及多系统的自身免疫疾病，其主要特征是能产生针对多种自身抗原的自身抗体。以抗核抗体（ANA）为主的多种自身抗体形成的免疫复合物在许多组织沉积，如肾小球、中枢神经系统、皮肤、关节等，触发Ⅲ型超敏反应，造成广泛组织损伤。引起多种临床表现。SEE作为一种典型的全身性自身免疫性疾病，其致病机制十分复杂，近年来在机制方面的研究获得很大进步。尤其是免疫方面的研究成果显著。本文就近年来发病机制的研究进展加以综述。     

以肺动脉高压首发的系统性红斑狼疮1例

患者：女,21岁,未婚,学生。因2周内反复发作晕厥3次入院。患者于入院前2周在乘地铁时无明显诱因出现黑噱,继之摔倒,1min左右清醒,1周后在家中再次晕厥,发作前有胸闷、乏力,无心悸,发作时伴牙关紧闭,双上肢抽搐,无大、小便失禁。     

Graves病合并系统性红斑狼疮1例

病例:患者,女,35岁。因"反复腹胀、恶心、呕吐2个月,加重1 d"入院。患者入院前2个月曾因呕吐,伴反酸、嗳气,腹胀,偶感上腹隐痛来我院急诊就诊,无发热,无不洁饮食史。急诊予奥美拉唑(商品名:奥克)、多潘立酮片(商品名:吗丁啉)、复方消化酶治疗2 d后无改善,并出现频繁呕吐,含胆汁,腹胀明显但无腹痛,查腹部B型超声(B超):胆囊多发结石、腹水。查血白细胞(WBC)、中性粒细胞及血淀粉酶显著升     

系统性红斑狼疮合并强直性脊柱炎一例

系统性红斑狼疮(systemic lupus erythematosus，SLE)是一种自身免疫性疾病，病因不明，可能与激素、环境、遗传等因素作用引起机体免疫调节紊乱有关。SLE与皮肌炎(dermatomyositis，DM)、硬皮病、类风湿关节炎(rheumatoid arthritis，RA)、下燥综合征(Sjoegren syndrome，SS)等合并．而与强直性脊柱炎(ankylosing spondylitis，AS)合并鲜有报道。现将我们在工作中遇到的1例SLE合行AS患者报道如下。     

The relationship between serum ferritin levels and disease activity in systemic lupus erythematosus

OBJECTIVE: The aim of this study is to investigate the relationship between serum ferritin levels and disease activity in patients with systemic lupus erythematosus (SLE). METHODS: Serum ferritin levels of 72 SLE patients were measured. The SLE patients were subdivided into two groups according to SLE disease activity index (SLEDAI) as < or = 10 and > or = 11. The results were compared with 31 patients with rheumatoid arthritis (RA). 36 patients among 72 with SLE were evaluated before and after treatment. RESULTS: Serum levels of ferritin in SLE patients were higher than RA patients (p < 0.001). There was a significant difference in ferritin levels before and after treatment. The levels of ferritin in SLE were positively correlated with SLEDAI scores. Patients with SLEDAI scores > or = 11 had significantly higher serum ferritin levels. CONCLUSION: Serum ferritin levels may be a useful marker of disease activity in SLE patients.     

Cytokine production, serum levels and disease activity in systemic lupus erythematosus

OBJECTIVE: T cell abnormalities, B cell hyperactivity and abnormal cytokine production have been implicated to be of pathogenic importance in systemic lupus erythematosus (SLE). The aim of this study was to investigate if ongoing production and serum levels of type 1 and 2 cytokines reflect disease activity and the presence of organ manifestations. METHODS: Fifty-two SLE patients and 29 healthy individuals were investigated. Blood samples were collected for assessment of anti-ds DNA antibodies, cytokine production and serum cytokine levels. Disease activity was simultaneously assessed using the Systemic Lupus Activity Measure (SLAM) index and SLE Disease Activity Index (SLEDAI). ELISPOT analysis of freshly isolated peripheral blood mononuclear cells (PBMC) was used to estimate the production of cytokines (gamma-interferon (IFN-gamma), interleukin-4 (IL-4), IL-6 and IL-10) using both unstimulated cells and cells stimulated with the T cell mitogen phytohaemagglutinin (PHA). Serum levels of IL-10 were determined using an ELISA method, serum levels of IL-6 were determined using a bioassay and anti-ds DNA antibodies were analysed by immunofluorescence. RESULTS: The SLE patient group had significantly increased numbers of cells spontaneously producing IL-10 and IL-6 as compared to healthy controls (P = 0.01 and 0.03, respectively). The number of cells producing IL-10 and IL-6 after PHA-stimulation was also increased in SLE patients (P = 0.01 and < 0.0004, respectively). Serum IL-10 and IL-6 levels were also significantly increased in SLE patients (P < 0.0004 and 0.0005, respectively). Serum IL-10 levels correlated with the titre of anti-ds DNA antibodies in the patients. No correlation was found between disease activity or clinical profiles and the production or serum levels of cytokines except for a weak correlation (not statistically significant) between levels of IL-10 in the sera and disease activity as measured by the SLEDAI but not by the SLAM index. CONCLUSION: Our results confirm earlier reports that SLE patients have an increased production as well as increased serum levels of the type 2 cytokines IL-10 and IL-6. We found no significant correlation between IL-6 and IL-10 and disease activity or clinical profiles. Serum IL-10 levels correlated with the titre of anti-ds DNA antibodies in the SLE patients. In summary, our result indicate that the increased IL-10 production in SLE could be constitutive.     

系统性红斑狼疮患者CD1的表达与疾病活动性的相关性

目的研究系统性红斑狼疮(SLE)患者外周血CD1的表达与疾病活动性之间的关系。方法用流式细胞仪检测了47例SLE患者外周血单个核细胞CD1c及CD1d的表达及淋巴细胞亚群百分数。结果SLE活动组病人CD1c+及CD1d+细胞百分率显著增高(P<0.05),CD4+细胞百分率显著降低(P<0.01),CD3+、CD8+细胞百分率正常,CD20+细胞数增高(P<0.01)。稳定期病人CD1c+及CD1d+细胞百分率正常,CD4+、CD8+、CD20+细胞百分率均正常。SLE患者CD1c+、CD1d+细胞阳性率与患者SLEDAI的评分有显著的相关性(r=0.68与r=0.66,P<0.01),与抗dsDNA抗体的表达有显著相关性(r=0.36与r=0.41,P<0.05);SLE患者CD1c+细胞阳性率与抗磷脂抗体(ACA)的表达有显著的相关性(r=0.68,P<0.01),与血清C3水平有显著相关性(r=-0.35,P<0.05)。经治疗后CD1c及CD1d的表达明显下降。结论系统性红斑狼疮患者外周血CD1c与CD1d的表达与疾病的活动性明显相关,CD1c、CD1d可能在SLE脂类抗原及核酸类抗原的递呈及抗dsDNA抗体、抗磷脂抗体的产生中起重要作用。     

Elevated serum interleukin-34 level in juvenile systemic lupus erythematosus and disease activity

Clinical Rheumatology - To determine the role of Interleukin-34 (IL-34) in the pathogenesis of juvenile systemic lupus erythematosus (J-SLE), by exploring the relationship between IL-34...     

Patterns of disease activity in systemic lupus erythematosus

OBJECTIVE: To describe patterns of systemic lupus (SLE) disease activity over time. METHODS: Disease activity was measured in a prospective cohort of 204 consecutive SLE patients followed up quarterly for 2.0-7.5 years (911 person-years of followup). Physician's global assessment (PGA) and modified SLE Disease Activity Index (M-SLEDAI; omitting serology) scores were plotted against time for each patient. Definitions for disease activity patterns were developed by consensus using these plots, and the proportion of total follow-up time represented by each pattern was calculated. RESULTS: Three patterns of SLE activity were apparent: relapsing-remitting (RR), chronic active (CA), and long quiescent (LQ). The CA pattern was the most frequent for both the PGA and M-SLEDAI, representing 58% and 40% of total person-years, respectively. The least common pattern was LQ (PGA 16%, M-SLEDAI 25%), while the RR pattern was intermediate in frequency (PGA 26%, M-SLEDAI 35%). Average disease activity during RR periods tended to be mild, while that during CA periods was more likely to be moderately severe. The most common discrepancy between instruments was that the PGA depicted CA when the M-SLEDAI showed an RR pattern. The M-SLEDAI did not appear to capture mild degrees of activity. CONCLUSION: SLE activity was readily classified into 1 of 3 patterns: RR, CA, or LQ. The CA pattern was most common, suggesting that significant morbidity may arise from persistent disease activity. These findings may have important implications regarding the choice of outcome measures in SLE clinical trials, since comparison of flare rates may not account for chronic disease activity.     

Correlation between serum levels of soluble tumor necrosis factor receptor and disease activity in systemic lupus erythematosus

Objective. To determine the value of measurement of serum soluble tumor necrosis factor receptor (sTNFR), compared with established parameters such as anti–double-stranded DNA, in monitoring systemic lupus erythematosus (SLE) disease activity, and to determine whether serum sTNFR are bioactive and can effectively inhibit TNF bioactivity. Methods. Fifty-three consecutive ambulatory or hospitalized SLE patients and 140 consecutive healthy subjects were enrolled in a prospective cohort study. Serum levels of sTNFR were measured by a unique 2-sided capture enzyme-linked immunosorbent assay using mouse monoclonal antibodies and rabbit antisera against the sTNFR. Results. The mean ± SD concentrations of both the p55 (type I) and p75 (type II) soluble receptors were significantly higher in a group of 46 SLE patients than in controls: 1.89 ± 0.89 ng/ml versus 0.77 ± 0.19 ng/ml and 7.25 ± 3.89 ng/ml versus 3.02 ± 0.57 ng/ml, respectively (P < 0.0001 for both). The incidence and the extent of the increase among the healthy subjects and these patients (as well as in 7 additional patients on whom sequential studies were performed) correlated with disease activity more than did the occurrence of serum anti-DNA antibodies (correlation coefficients with disease activity 0.81 and 0.85 for p55 and p75 sTNFR, respectively, and 0.51 for anti-DNA antibodies). The increase in sTNFR levels seems to reflect, largely, enhanced formation, and only to a minor extent, reduced clearance due to impairment of renal function. Sera of the SLE patients had a marked inhibitory effect on the in vitro cytocidal activity of TNF, and this was shown to result entirely from their higher sTNFR receptor concentration. Conclusion. An increase in serum levels of sTNFR may become a useful marker for SLE activity since it shows a stronger correlation than do any other laboratory or clinical parameters employed presently in the daily clinical setting. At the concentrations attained in the serum of SLE patients, sTNFR effectively inhibit the bioactivity of TNF and may thus be a significant determinant of the intensity of the manifestations of SLE.     

Relationship of phytohaemagglutinin-induced lymphocyte transformation to disease activity in systemic lupus erythematosus.

Phytohaemagglutinin-induced lymphocyte transformation was studied in 19 patients with systemic lupus erythematosus (SLE) in relation to disease activity, peripheral blood lymphocyte count, serum iron and folate levels, and corticosteroid treatment. Similar studies were performed on a group of 28 age- and sex-matched controls and on 10 patients with facial palsy who were examined before and after 7 days of high-dose corticosteroid treatment. The patients with SLE were found to have an impairment of lymphocyte transformation which was most marked in active stages of the disease and associated with a lymphopenia. This depressed transformation, which improved with the development of a remission, could not be attributed to the effects of corticosteroid treatment, inhibitory serum factors, iron deficiency, or any numerical reduction in blood lymphocytes, thus indicating along with evidence from other sources that SLE patients have a defect of cell-mediated immunity. The aetiological implications of these findings are discussed.     

Cigarette smoking and disease activity in systemic lupus erythematosus

OBJECTIVE: To investigate the effect of cigarette smoking on disease activity and cumulative organ damage in systemic lupus erythematosus (SLE). Methods. Extensive clinical and demographic variables, including current and previous cigarette smoking, were collected from 111 SLE patients using a detailed interview-administered questionnaire. Disease activity was estimated with the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Cumulative organ damage was measured by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR). Smoking status was correlated with disease activity and cumulative organ damage, while statistically adjusting for the individual effects of potentially confounding demographic and clinical variables using analysis of variance followed by Fisher's least significant difference method. Results. Current smokers demonstrated significantly higher (p < 0.001) SLEDAI scores (15.6 +/- 7.8) than ex-smokers (9.63 +/- 6.00), and never smokers (9.03 +/- 5.75). This association remained significant (p = 0.001) after adjusting for all covariates, including ethnicity, education level, income level, alcohol use, age of onset of SLE, current age, mean duration of SLE, marital status, and hydroxychloroquine therapy. Current smokers also demonstrated significantly (p = 0.003) higher scores for both the neurological and non-neurological components of SLEDAI. There was no significant difference in the SLICC/ACR scores across the various smoking groups, although there was a trend for more severe disease in current smokers. Conclusion. Cigarette smoking is associated with increased disease activity in SLE. These data further establish the association of SLE with cigarette smoking, and suggest that individuals with SLE should avoid all exposure to tobacco products.     

Relationship between serum NR2a antibodies and cognitive dysfunction in systemic lupus erythematosus

OBJECTIVE: To assess the association between serum NR2a antibodies and cognitive dysfunction in systemic lupus erythematosus (SLE). METHODS: The study population consisted of English-speaking adults who met American College of Rheumatology (ACR) criteria for SLE and had at least 1 serum sample stored in the Hospital for Special Surgery Autoimmune Registry and Repository. Demographic and clinical information was obtained, and patients completed the neuropsychological test battery recommended by the ACR, the Center for Epidemiologic Studies Depression Scale, and the Spielberger State-Trait Anxiety Inventory. Cognitive impairment was defined as scores >1.5 SD below the mean of age-matched published normative data on at least 2 neuropsychological tests. Sera were tested for NR2a antibodies by enzyme-linked immunosorbent assay. Performance on neuropsychological tests was compared between NR2a-positive and NR2a-negative patients. RESULTS: Of the 93 patients, 24 (25.8%) were positive for NR2a antibodies. Of the 48 patients who were cognitively impaired based on test results, 31% were positive for NR2a antibodies, compared with 20% of those who were not cognitively impaired (P = 0.24). Among antibody-positive patients, the mean +/- SD number of neuropsychological tests with abnormal results was 2.3 +/- 2.2, compared with 2.0 +/- 1.8 in the antibody-negative group (P = 0.59). Similar nonsignificant differences were found when impairment was defined using a more stringent definition (i.e., test scores >2.0 SD below the mean) and using a neuropsychologist's clinical ratings. No association was detected between NR2a antibody positivity and depressive symptoms (P = 0.73) or anxiety (P = 0.42). CONCLUSION: No significant association was found between NR2a antibody positivity and cognitive dysfunction, depressive symptoms, or anxiety. These results indicate that the presence of these antibodies alone does not have a direct effect on cognitive functioning or any other neuropsychiatric manifestation of SLE.