狼疮性肾炎患者血浆中内皮细胞损伤标志物的变化及意义

目的探讨血浆可溶性血栓调节蛋白(sTM)及可溶性内皮细胞蛋白C受体(sEPCR)水平与狼疮性肾炎(LN)关系。方法采用酶联免疫吸附实验检测54例LN患者(LN组)及18例健康者(对照组)血浆sTM和sEPCR水平。结果 LN组血浆sTM、sEPCR水平分别为(32.87±13.39)ng/ml、(180.97±14.92)ng/ml,均明显高于对照组的(18.04±3.72)ng/ml、(147.68±34.97)ng/ml(P均<0.01)。Ⅳ型LN患者sTM和sEPCR水平均高于Ⅲ型和Ⅴ型患者(P均<0.05)。LN组sTM与sEPCR呈正相关关系(P<0.05);sTM、sEPCR均与尿蛋白水平及狼疮活动指数呈正相关关系(P均<0.05);sTM与血清内生肌酐清除率呈负相关关系(P<0.05)。结论 LN存在血管内皮损伤,血浆sTM及sEPCR水平可作为判断LN疾病活动性及肾脏损伤程度的指标。

Changes of Plasma Markers of Endothelial Injury in Patients With Lupus Nephritis and Its Clinical Significance

Objective To investigate the association of plasma levels of soluble thrombomodulin(sTM) and soluble endothelial protein C receptor(sEPCR) with lupus nephritis(LN).Methods The plasma levels of sTM and sEPCR were measured by enzyme-linked immunosorbent assay(ELISA) in 54 patients with LN(LN group) and 18 normal controls(control group).Results The plasma levels of sTM and sEPCR in LN group (32.87±13.39)ng/ml,(147.68±34.97)ng/ml)] were significantly higher than those(18.04±3.72)ng/ml,(147.68±34.97)ng/ml] in NC group(all P<0.01).The plasma levels of sTM and sEPCR in type Ⅳ LN patients were higher than those in type Ⅲ and Ⅴ LN patients(P<0.05).In LN group,sTM was positively correlated with sEPCR(P<0.05);The plasma levels of sTM and sEPCR were both positively correlated with systemic lupus erythematosus disease activity index(SLEDAI) and proteinuria level(all P<0.05);sTM was negatively correlated with serum Ccr(P<0.05).Conclusion Endothelial injury occurs in patients with LN.The plasma levels of sTM and sEPCR can be used as the indices for the diagnosis of the disease activity and the severity of renal injury.