【摘要】 目的研究系统性红斑狼疮(systemiclupuserythematosus,SLE)患者血清可溶性标准型CD44(solublestandardformCD44,sCD44std)水平,并探讨其临床意义。方法采用双抗体夹心酶联免疫吸附测定法,检测了28名健康人和67例SLE患者血清sCD44std水平。根据狼疮活动计算标准(lupusactivitycountcriteria,LACC)确定疾病活动组与稳定组,其中活动组49例、稳定组18例,其中16例活动组患者经治疗病情稳定3个月后复查血清,作治疗前后的比较。结果SLE患者血清sCD44std水平明显高于正常对照组(P<0.01),且活动组明显高于稳定组(P<0.01)。血清sCD44std水平在肺病变组、脑病组、肾脏损害组分别显著高于无肺病变组、无脑病组、无肾脏损害组(P均<0.05)。且血清sCD44std水平与24h尿蛋白定量、尿微量白蛋白、尿转铁蛋白、尿IgG呈正相关(P<0.01);与血清IgG、血清IgM呈正相关(P<0.01);与血清C3呈负相关(P<0.01)。16例活动组患者经治疗病情稳定3个月后血清复查,血清sCD44std在治疗稳定后明显下降(P<0.01)。结论血清sCD44std水平与SLE疾病活动性有关,可作为SLE疾病活动和疗效观察的监测指标之一。sCD44std水平升高提示SLE重要脏器(肺、脑、肾)损害的可能;且可作为肾小球损害的早期监测指标之一。更多还原

【Abstract】 Objective To study the levels of CD44std in patients with systemic lupus erythematosus (SLE), and their clinical significances were investigated. Methods Serum levels of sCD44std were measured by enzyme-linked immunosorbent assay (ELISA), and 28 healthy controls and 67 patients with SLE were evaluated in this study. Forty-nine patients with active SLE were defined according to the lupus activity count criteria (LACC). Results Serum levels of sCD44std in patients were significantly increased as compared with controls (P<0.01), moreover, serum levels of sCD44std in patients with active SLE were significantly higher than those of the inactive (P<0.01), and significantly correlated with the disease activity (OR=1.008, P<0.05). Serum levels of sCD44std in groups of patients with pulmonary, cerebral and renal involvement were significantly higher than those without these clinical manifestations, significantly positive correlation between serum levels of sCD44std and 24 hour urine protein excretion, urinary transferrin, urinary microalbumin and urinary immunoglobulin G were found (r=0.349, P<0.01; r=0.350, P<0.01; r=0.217, P<0.05; r=0.366, P<0.01) and there was no correlation between serum levels of sCD44std and endogenous creatinine clearance rate (Ccr) or urinary α1-microglobulin (r=-0.070, P>0.05, r=0.209, P>0.05). There was a significantly positive correlation between serum levels of sCD44std and serum levels of IgM and IgG (r=0.419, P<0.01, r=0.400, P<0.01), and negative correlation with C3 levels (r=-0.327, P<0.01), but no significant correlation with erythrocyte sedimentation rate (ESR) and C realtive protein (CRP) (r=-0.197, P>0.05; r=0.015, P>0.05). After treated for 3 months, serum levels of sCD44std were markedly decreased in 16 patients with SLE (P<0.01). Conclusion The present data suggests that sCD44std may be involved in the pathogenesis of SLE , sCD44std level may be used as one of the sensitive indicators for disease activity and treatment effectiveness of SLE. The serum level of sCD44std in patients with SLE may indicate pulmonary, cerebral and renal involvement, and serum level of sCD44std may be an early sensitive indicator of renal involvement.更多还原