阴性少免疫沉积型新月体性肾炎患者血清AECA与临床表现的关系研究

目的：探讨抗中性粒细胞胞浆抗体（ANCA）阴性少免疫沉积型新月体性肾炎患者血清抗内皮细胞抗体（AECA）表达情况，及其与临床表现的关系。方法：选取2010年至2015年在我院治疗的少免疫沉积型新月体性肾小球肾炎患者，其中ANCA阴性患者45例（观察组），ANCA阳性患者49例（对照组），采用Western blot检测各组患者血清AECA水平。结果：观察组平均年龄和伯明翰血管炎活动性评分（BVAS）分别为（4108±943）岁和（1503±382）分，明显低于对照组（P＜005）；观察组出现发热、关节痛的比例分别为2667%和1333%，明显低于对照组（P＜005）；观察组出现肾病综合征比例为4889%，高于对照组（P＜005）；观察组血清AECA阳性率为4667%，明显低于对照组的8163%（P＜005）；观察组IgG AECA共识别7种蛋白，而对照组共识别11种蛋白，其中观察组抗90 kD抗体阳性率为1333%（6/45），明显低于对照组的5102%（25/49）（P＜005）；观察组抗76 kD抗体阳性患者出现皮疹的比例为100%，明显高于阴性患者（P＜005），抗200 kD抗体阳性患者BVAS评分为（1802±251）分，明显高于阴性患者（P＜005）。 〖HTH〗结论：〖HTSS〗ANCA阴性少免疫沉积型新月体性肾炎患者血清存在不同的AECA,可能与某些临床表现有关；ANCA阴性和阳性患者AECA有所不同，两者临床表现的差异可能与AECA的不同有关，需待进一步研究。

Relationship between serum AECA and clinical signatures of ANCA negative pauci-immune deposition type crescentic glomerulonephritis patients

  Objective:〖WT5”BZ〗To investigate the expression of anti endothelial cell antibodies(AECA) in patients serum with anti neutrophil cytoplasmic antibody(ANCA) negative pauci immune deposition type crescentic glomerulonephritis and its relationship with clinical signatures 〖WTHZ〗Methods: 〖WTBZ〗We selected 94 pauci immune deposition type crescentic glomerulonephritis patients from 2010 to 2015 treated in our hospital,45 of which with ANCA negative(observation group) and 49 cases of ANCA positive patients (control group),AECA levels of each groups serum were detected by Western blot test.Results: The average age of the observation group and Bermingham vasculitis activity score(BVAS) respectively (4108 + 943) years old and (1503 + 382),significantly lower than the control group (P<005);the observation group had fever,joint pain accounted for 2667% and 13.3%,significantly lower than the control group (P<005);the observation group of nephrotic syndrome accounted for 4889%,higher than the control group (P<005);observation group positive rate of serum AECA was 4667%,significantly lower than the control group 8163% (P<005);the observation group IgG AECA identified 7 proteins,while the control group had identified 11 proteins,of which the observation group the positive rate of anti 90 kD antibody was 1333%(6/45),significantly lower than the control group 5102%(25/49) (P<005);observation group of anti 76 kD antibody positive patients had rash ratio of 100%,significantly higher than negative patients (P<005),anti 200 kD antibody positive the BVAS score of the patients was (1802 + 251),which was significantly higher than that of the negative patients (P<005).Conclusion: The different level of AECA in ANCA negative pauci immune crescentic glomerulonephritis patients may be associated with certain clinical manifestations;clinical manifestations differences between the ANCA negative and positive patients may be associated with different expression of the AECA related,the detail need a further study.