系统性红斑狼疮患者狼疮性肾炎诊断的多指标临床评价

目的 探讨血清尿素、血清肌酐、血清胱抑素C、尿微量白蛋白、尿转铁蛋白、尿α1-微球蛋白、尿N-乙酰-β-D葡萄糖苷酶和尿足细胞标志蛋白,在系统性红斑狼疮（SLE）患者狼疮性肾炎（LN）诊断中的临床价值.方法 对SLE合并LN患者41例、SLE未合并LN患者15例和50例健康对照组血清进行Urea、Cr和Cys C水平测定,同时对尿液中MA、TRU、α1-MG、NAG和PCX水平进行测定.结果 SLE合并LN患者血清urea、Cr和Cys C水平及尿液PCX、TRU、MA、NAG、α1-MG水平都显著高于SLE未合并LN患者和对照组（均P＜0.05）.结论 血cys C、尿TRU和尿α1-MG联合检测既可同时监测LN患者的肾小球滤过功能损害、肾小球滤过膜损害和近端肾小管损害,又可提高灵敏度,是SLE患者早期肾损害的敏感、方便、有效的指标.

Clinical evaluation of multiple index for diagnosis of lupus nephritis in the patients with systemic lupus erythematosis

Objective To explore clinical value of serum urea, serum creatinine（ Cr）, serum cystatin C（ Cys C）, urine microalbumin（MA）, transferrinuria（TRU）, urine a,-microglobulin（α1-MG）, urine N-acetyl-β-glucosaminidase（NAG） and urine podocalyxin （PCX） for diagnosis of lupus nephritis（ LN） in the patients with systemic lupus erythematosis（ SLE）. Methods The levels of urea, Cr and Cys C were measured in the sera from 41 SLE patients with LN, 15 SLE patients without LN and 50 healthy control group, meanwhile, the levels of MA, TRU ,α1 -MG, NAG and PCX in urine from them were measured. Results The levels of urea, Cr, Cys C, MA, TRU, α1-MG, NAG and PCX were higher in SLE patients with LN than these in SLE patients without LN and healthy control group （ P 〈 0. 05）. Conclusion They were the sensitive, simple, and effective indexes for the diagnosis of early renal injury in the patients with SLE.