【摘要】 目的检测系统性红斑狼疮(SLE)患者血清可溶性黏附分子水平,并分析其与SLE不同中医辨证分型的相关性及诊断价值。方法选取SLE患者46例,辨证分型为热毒炽盛型19例,脾肾阳虚型14例,肝肾阴虚型13例,取晨起空腹静脉血,采用ELISA法检测其血清可溶性细胞间黏附分子-1(SICAM-1)及血管内皮细胞黏附分子-1(SVCAM-1)水平变化,并设同期来院体检正常者40例为对照组,进行对比分析。结果各证型血清SICAM-1、SVCAM-1水平均显著高于对照组(P<0.05);热毒炽盛型血清SICAM-1、SVCAM-1水平显著高于脾肾阳虚型及肝肾阴虚型(P<0.05);脾肾阳虚型2项指标显著高于肝肾阴虚型(P<0.05);SLE狼疮活动积分及ESR以热毒炽盛型最高,依次为脾肾阳虚型及肝肾阴虚型(P<0.05);热毒炽盛型及脾肾阳虚型补体C3滴度显著低于肝肾阴虚型(P<0.05);SICAM-1与SVCAM-1两种分子间呈正相关性(P<0.01);血清SICAM-1、SVCAM-1水平与狼疮积分、ERS呈正相关(P<0.01);与补体C3呈负相关(P<0.01)。结论血清SICAM-1、SVCAM-1水平测定可作为判定SLE活动的重要指标,检测SLE患者血清可溶性黏附分子水平可作为中医辨证论治辅助指标。更多还原

【Abstract】 Objective To detect the serum soluble adhesion molecule level in the SLE patients and to analyze its relationship with different SLE syndrome differentiation of TCM and its diagnostic value. Methods A total of 46 SLE patients were enrolled in our study,among which 19 cases belonged to the type of heat-toxin flaming,14 had spleen-kidney-yang deficiency,and 13 had liver-kidney-yin deficiency according to the syndrome differentiation of TCM. The morning fasting venous blood of all subjects was obtained to detect the changes of levels of SICAM-1 and SVCAM-1 by ELISA. A total of 40 healthy individuals who came for physical examination at the same stage were served as the control and comparative analysis was conducted. Results The levels of serum SICAM-1 and SVCAM-1 in all types of the SLE patients were significantly higher than those in the control group( P < 0. 05); the levels of serum SICAM-1 and SVCAM-1 in the heat-toxin flaming type were significantly higher than those in the patients with spleen-kidney-yang deficiency and liver-kidney-yin deficiency( P < 0. 05); the levels of these two indicators in the spleen-kidney-yang deficiency patients were significantly higher than those in the liver-kidney-yin deficiency patients( P < 0. 05); the heattoxin flaming patients had the highest SLE disease activity index( SLEDAI) and ESR,secondly,was the spleen-kidney-yang deficiency patients,and the liver-kidney-yin deficiency patients had the least( P < 0. 05); the C3 titers in the heat-toxin flaming and spleen-kidney-yang deficiency patients were significantly lower than those in the liver-kidney-yin deficiency patients( P < 0. 05); while the comparison of the C3 titers between the heat-toxin flaming and spleen-kidney-yang deficiency patients was not statistically different( P > 0. 05); there was a positive correlation of SICAM-1 and SVCAM-1 in the SLE patients( P < 0. 01); The serum SICAM-1 and SVCAM-1 levels were positively correlated with the SLEDAI( P < 0. 01) and ESR( P < 0. 01),and were negatively correlated with C3( P < 0. 01). Conclusion The detection of serum SICAM-1 and SVCAM-1 levels can be used as an important indicator to predicate SLE activity,and determination of serum soluble adhesion molecule levels in the SLE patients can be served as an auxillary index of syndrome differentiation and treatment of TCM.更多还原