补体片段C5a与系统性红斑狼疮及其神经系统损害的关系

目的:检测系统性红斑狼疮（SLE）患者血清和脑脊液中补体片段C5a水平，探讨C5a与SLE及其神经系统损害的关系及其临床意义。方法: 选取天津医科大学总医院风湿免疫科住院的SLE患者23例，收集其外周血及脑脊液，根据有无神经精神受累分为神经精神狼疮（NPSLE）组和非NPSLE组，16例NPSLE患者中8例进行了治疗前后配对比较；同时收集17例健康对照外周血。采用ELISA方法测定血清及脑脊液中C5a水平，比较上述各组间血清及脑脊液中C5a差异，并采用Pearson相关分析NPSLE组血清C5a与脑脊液C5a的相关性。结果: SLE患者血清C5a水平明显高于健康对照，NPSLE患者的血清及脑脊液C5a水平明显高于非NPSLE患者，且NPSLE患者治疗后血清及脑脊液C5a水平明显降低，差异均具有统计学意义（P<0.05）；NPSLE患者血清与脑脊液中的C5a水平呈正相关关系（r=0.703，P=0.002）。结论:监测血清及脑脊液中补体片段C5a的水平有助于NPSLE的病情评估及疗效判断。

The effect of C5a on systemic lupus erythematosus and its damage of nervous system

Objective: To detect the level of complement fragment C5a in serum and cerebrospinal fluid(CSF) in patients with systemic lupus erythematosus(SLE), and to explore the effect of C5a and SLE on damage of nervous system. Methods: Twenty-three patients with SLE admitted to the Department of Rheumatology and Immunology of Tianjin Medical University General Hospital were enrolled. Peripheral blood and CSF were collected. The neuropsychiatric lupus (NPSLE) group and non-NPSLE group were included according to the presence or absence of neuropsychiatric involvement. Eight patients in the NPSLE group were compared before and after treatment; Peripheral blood from 17 healthy controls was also collected. The levels of C5a in serum and CSF were determined by ELISA. The differences in C5a in serum and CSF between the above groups were compared, and the correlation between serum C5a and CSF C5a in NPSLE group was analyzed by Pearson correlation. Results: Serum C5a levels in SLE patients were significantly higher than those in healthy controls,the serum and CSF C5a levels in NPSLE patients were significantly higher than those in non-NPSLE patients, and the serum and CSF C5a levels were significantly lower after treatment (P<0.05); serum C5a levels in NPSLE patients were positively correlated with CSF C5a levels(r=0.703, P=0.002). Conclusion: Monitoring the level of complement fragment C5a in serum and CSF may contribute to the evaluation and efficacy of NPSLE.