皮损FLT-1和KDR水平的测定对SLE患者疾病活动性及治疗转归的预测价值

目的:探讨系统性红斑狼疮(systemlupus erythematosus,SLE)患者皮损血管内皮生长因子受体FLT-1和KDR水平的测定对疾病活动性及治疗转归的预测价值。方法:采用免疫组化(SP免疫组织化学法)法检测皮损FLT-1及KDR蛋白的表达水平,分析FLT-1和KDR的含量与SLE患者的疾病活动度指数SLEDAI和免疫指标(ANA、ds DNA等)的相关性,研究用FLT-1和KDR指标判断疾病的活动性,并进行SLE病例的前瞻性和治疗前后对照研究。结果:SLE患者皮损血管内皮生长因子受体FLT-1和KDR水平显著高于正常对照组。SLE患者皮损血管内皮生长因子受体FLT-1和KDR水平活动期均高于非活动期(P<0.01),抗核抗体(ANA)高滴度组高于ANA低滴度组,dsDNA抗体阳性组高于dsDNA抗体阴性组,肾损害组高于非肾损害组;且SLE患者皮损血管内皮生长因子受体FLT-1和KDR水平与SLE患者SLEDAI呈正相关。结论:FLT-1和KDR与SLE发病有关,可反映SLE患者的疾病活动性,同时定量检测可有助于预测患者的病情活动和转归。

Predictive value of FLT-1 and KDR level in judging SLE activity and its prognosis

Objective： To investigate the predictive value of vascular endothelial growth factor receptor FLT-1 and KDR levels in systemic lupus erythematosus （system lupus erythematosus, SLE） patients with skin lesions. Methods： SP immunohistochemical method was used to detect expression levels of FLT-1 and KDR protein in SLE patients with skin lesions, Correlation among the FLT-1 and KDR level, SLE disease activity index （SLEDAI） and immune indicators （ANA , ds DNA, etc. ） were analyzed to in- vestigate the possibility of judging the SLEDAI according to FLT-1 and KDR level. Prospective study and comparison of patients status before and after treatment were also conducted. Results： Vascular endotheli- al growth factor receptor FLT-1 and KDR levels in SLE patients with skin lesions were significant higher than that in the control group. Among SLE patients, FLT-1 and KDR levels of active stage were higher than that of stable stage （P〈0.01）; anti-nuclear antibody （ANA） high-titer group higher than the low-titer group; dsDNA antibody-positive group higher than the negative group, renal impairment group higher than the non--renal injury group. Levels of vascular endothelial growth factor receptor FLT-1 and KDR in SLE patients were positively correlated with SLEDAI. Conclusions： Quantitative detection of FLT-1 and KDR level can predict the progonosis of SLE patients because they are related to the onset of SLE and SLEDAI.