抗核小体抗体与抗C1q抗体在狼疮肾炎血清的表达及其临床意义

目的探讨抗核小体抗体与抗C1q抗体在狼疮肾炎（lupus nephritis，LN）患者血清的表达及其临床意义。方法使用酶联免疫吸附试验（ELISA）对46例LN患者血清进行检测，并与31例无肾炎临床表现的SLE患者作对照。结果LN患者血清中抗核小体抗体与抗C1q抗体浓度及阳性率显著高于SLE对照组（P〈0．01）。抗双链DNA（dsDNA）抗体、抗Sm抗体、抗nRNP抗体、抗心磷脂（aCL）IgG抗体有较高的阳性率，与对照组相比差异有统计学意义（P〈0．05）。将抗核小体抗体、抗C1q抗体、抗dsDNA抗体、抗Sm抗体、抗nRNP抗体和aCLIgG抗体分别引入Logistic回归进行统计分析，结果显示入选的自变量包括抗核小体抗体、抗C1q抗体、抗dsDNA抗体（P〈0．05）。结论在LN患者中，存在着抗核小体抗体、抗C1q抗体的高表达。抗核小体抗体及抗C1q抗体在LN发病中起重要的作用。抗核小体抗体、抗C1q抗体、抗dsDNA抗体是反映SLE患者并发肾脏损害的重要指标，在LN诊断和判定其活动性方面有重要作用。

Expression and clinical significance of anti-nucleosome antibodies and anti-C1q antibodies in sera of patients with lupus nephritis

Objective To explore the expression of anti-nucleosome antibodies and anti-C1q antibodies as well as their clinical significance in patients with lupus nephritis (LN). Methods ELISA assay was performed to examine anti-nucleosome antibodies and anti-C1q antibodies in the sera of 46 patients with LN and 31 patients of systemic lupus erythematosus without renal damage. Standard methods were used for laboratory testing. Results Anti-nucleosome antibodies and anti-C1q antibodies were significantly higher in LN than in controls (P<0.01). The positive rate of anti-nucleosome antibodies and anti-C1q antibodies was significantly higher in LN than in controls. There was significant and positive correlation between anti-nucleosome antibodies or anti-C1q antibodies and SLEDAI score in LN (P<0.01). The laboratory tests showed that the positive rate of anti-dsDNA, anti-Sm, anti-nRNP, aCLIgG was higher in the group with nephritis than in control groups (P<0.05). In multivariate analysis the factors associated with LN were anti-dsDNA antibodies, anti-nucleosome antibodies and anti-C1q antibodies (P<0.05). Conclusion In patients with LN, anti-nucleosome antibodies and anti-C1q antibodies are significantly higher than control groups. Anti-nucleosome antibodies and anti-C1q antibodies are suggested to play a role in the pathogenesis of LN. Anti-nucleosome antibodies, anti-C1q antibodies and anti-dsDNA antibodies can be used as diagnostic tools and disease activity markers.