抗Sm抗体对儿童系统性红斑狼疮疾病活动性及狼疮性肾炎的影响

目的：探讨血清抗Sm抗体与儿童系统性红斑狼疮（ SLE）疾病活动性的关系及其在狼疮性肾炎（ LN）中的影响。方法收集2005年1月至2014年12月福建医科大学附属第二医院儿科收治的70例儿童SLE患者资料，检测所有患儿血清抗Sm抗体，评估 SLE疾病活动性及 LN病理组织学分型。根据抗Sm抗体的定性情况，分为抗Sm抗体阳性组和抗Sm抗体阴性组，分析抗Sm抗体与SLE疾病活动和LN之间的关系。结果抗Sm抗体阳性组出现肾损害高于抗Sm抗体阴性组（82．6％比55．3％，P＜0．05）。两组 SLE疾病活动性均以中度活动比例最高，但各活动水平的比较无差异（P＞0．05）。抗体阳性组肾脏病理Ⅲ、Ⅳ型中检出率明显高于阴性组（P＜0．05）。结论抗Sm抗体与儿童SLE疾病活动程度无明显相关，但抗Sm抗体阳性患儿更易出现肾损伤且病理表现更为严重。

Effect of Anti Smith Antibody Children with Systemic Lupus Erythematosus Disease and Lupus Nephritis in

ABSTRACT:OBJECTIVE To investigate the relationship among serum anti Smith antibody and the disease activ-ity in children with systemic lupus erythematosus ( SLE) and the effect on lupus nephritis ( LN).METHODS A to-tal of 70 cases with SLE were enrolled from the inpatients of Second Affiliated Hospital of Fujian Medical College .All children′serum anti Smith antibody were detected .SLE disease activity and LN histopathological type were as-sessed.According to the qualitative case of anti-Smith antibody ,the cases were divided into anti-Smith antibody posi-tive group and negative groups .The relationship among anti-Smith antibody and SLE disease activity and LN were an-alyzed.RESULTS Renal injury in anti-Sm antibody positive group was higher than that of anti Sm antibody nega-tive group (82.6%vs.55.3%,P<0.05).In the two groups,the moderate activity of SLE disease was the highest , but the activity level was not different (P>0.05).In renal pathology,the positive rate of ⅢandⅣtype was signifi-cantly higher than that in the negative group ( P<0.05 ) .CONCLUSION There is no clear relationship between anti-Smith antibody and disease activity of SLE in children ,but anti-Sm antibody positive are more likely to appear serious kidney injury and pathology .