系统性红斑狼疮肾损害影响因素及与血尿酸水平的关系
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摘要
目的探讨系统性红斑狼疮肾损害影响因素及其与血尿酸水平的关系。方法选取我院2013年12月—2018年6月收治的系统性红斑狼疮(SLE) 220例,根据有无发生狼疮性肾炎分为LN组120例,非LN组100例,并选择同期体检健康者100例作为对照组。测定C反应蛋白(CRP)、血尿酸、免疫球蛋白指标等。应用SLE疾病活动指数(SLEDAI)判断疾病活动情况。结果 LN组高尿酸血症发生率高于非LN组(P <0. 05)。LN组和非LN组CRP均高于对照组,且LN组高于非LN组(P <0. 05); LN组血尿酸水平高于对照组和非LN组(P <0. 05)。同年龄、性别情况下,血尿酸、补体C3水平与LN发病相关(P <0. 05)。结论 SLE患者发生LN与C3、血尿酸有关,应根据患者具体情况确定治疗方案。
Objective To investigate influencing factors of renal injury in patients with systemic lupus erythematosus( SLE) and their correlations with serum uric acid level. Methods A total of 220 SLE patients admitted during December 2013 and June 2018 were divided into lupus nephritis group( LN group,n = 120) and non-LN group( n =100) according to whether or not having LN,and other 100 healthy persons taking physical examination were selected as control group. Levels of C-reactive protein( CRP),serum uric acid and immunoglobulin indexes were detected,and SLE disease activity index( SLEDAI) was used to identify condition of disease activity. Results Incidence rate of hyperuricemia in LN group was significantly higher than that in non-LN group( P < 0. 05). CRP levels in LN and non-LN groups were significantly higher than that in control group,and the level in LN group was significantly higher than that in non-LN group( P < 0. 05). Serum uric acid level in LN group was significantly higher than those in control and non-LN groups( P < 0. 05). Levels of serum uric acid and complement C3 were related to LN pathogenesy when patients had same age and gender( P < 0. 05). Conclusion LN pathogenesy in patients with SLE is related to complement C3 and serum uric acid,and therefore treatment plan should be determined according to specific conditions of patients.
Objective To investigate influencing factors of renal injury in patients with systemic lupus erythematosus( SLE) and their correlations with serum uric acid level. Methods A total of 220 SLE patients admitted during December 2013 and June 2018 were divided into lupus nephritis group( LN group,n = 120) and non-LN group( n =100) according to whether or not having LN,and other 100 healthy persons taking physical examination were selected as control group. Levels of C-reactive protein( CRP),serum uric acid and immunoglobulin indexes were detected,and SLE disease activity index( SLEDAI) was used to identify condition of disease activity. Results Incidence rate of hyperuricemia in LN group was significantly higher than that in non-LN group( P < 0. 05). CRP levels in LN and non-LN groups were significantly higher than that in control group,and the level in LN group was significantly higher than that in non-LN group( P < 0. 05). Serum uric acid level in LN group was significantly higher than those in control and non-LN groups( P < 0. 05). Levels of serum uric acid and complement C3 were related to LN pathogenesy when patients had same age and gender( P < 0. 05). Conclusion LN pathogenesy in patients with SLE is related to complement C3 and serum uric acid,and therefore treatment plan should be determined according to specific conditions of patients.
引文
[1]杨玫,祝艳,张敏,等. Fli-1在外周血T/B细胞中的表达及其与系统性红斑狼疮的相关性研究[J].中华疾病控制杂志,2014,18(7):630-634.
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[9]谢婷婷,陈梦颖,唐湘玲,等.高尿酸血症是狼疮性肾炎患者肾病理损伤及预后不良的独立危险因素[J].中南大学学报:医学版,2016,41(10):1052-1057.
[10]龙君.系统性红斑狼疮肾损伤患者血清CRP、血尿酸和免疫球蛋白水平的变化及意义J].海南医学院学报,2017,23(16):2218-2220,2224.
[11]宁春艳,党西强,宋芳,等.狼疮性肾炎患儿血管损伤中心肌素与miR-145的表达情况及其临床意义研究[J].中国全科医学,2016,19(31):3831-3836.
[12] Wang Z,Wang Y,Zhu R,et al. Long-term survival and death causes of systemic lupus erythematosus in China:a systemic review of observational studies[J]. Medicine(Baltimore),2015,94(17):e794.
[13]彭家清.尿酸和血清胱抑素C对高血压肾损害早期诊断的预测价值[J].浙江临床医学,2014,16(5):705-707.
[14] Hsieh Y P,Chang C C,Yang Y. et al. The role of uric acid in chronic kidney disease patients[J]Nephrology(Carlton),2017,22(6):441-448.
[15] Chang Y H,Lei C C,Lin K C,et al. Serum uric acid level as an indicator for CKD regression and progression in patients with type 2 diabetes mellitus-a 4. 6-year cohort study[J]. Diabetes Metab Res Rev,2016,32(6):557-564.
[2]康乐,李辉,张晓东,等.中西医结合治疗慢性肾小球肾炎临床研究[J].中医学报,2014,29(2):272-274.
[3]唐莉.别嘌呤醇联合痛风定胶囊对痛风患者炎症因子、肝肾功能及相关指标的影响研究[J].海南医学院学报,2016,22(21):2551-2554.
[4]朱晨曦,刘双,杨京华,等.肺动脉高压血浆脑钠肽及血尿酸水平与血流动力学变化的相关性研究[J].心肺血管病杂志,2015,34(5):376-379.
[5]房树标,王永辉,李艳彦,等.基于NLRP3炎性体信号通路研究桂枝芍药知母汤对尿酸钠诱导大鼠巨噬细胞炎性信号表达影响[J].中国中医基础医学杂志,2016,2(4):472-476.
[6] Plantinga L C,Drenkard C,Pastan S O,et,Attribution of cause of end-stage renal disease among patients with systemic lupus erythematosus:the Georgia Lupus Registry[J]. Lupus Sci Med,2016,3(1):e000132.
[7] Cimbaluk D,Naumann A. Renal involvement in systemic lupuserythematousus:glomerular pathology,classification and future directions[J]. Diagnostic histopathology,2017,23(3):109-116.
[8]欧姆,梁孟君,张望,等.狼疮肾炎患者高尿酸血症患病率及其危险因素分析[J].中华肾脏病杂志,2014,30(11):805-812.
[9]谢婷婷,陈梦颖,唐湘玲,等.高尿酸血症是狼疮性肾炎患者肾病理损伤及预后不良的独立危险因素[J].中南大学学报:医学版,2016,41(10):1052-1057.
[10]龙君.系统性红斑狼疮肾损伤患者血清CRP、血尿酸和免疫球蛋白水平的变化及意义J].海南医学院学报,2017,23(16):2218-2220,2224.
[11]宁春艳,党西强,宋芳,等.狼疮性肾炎患儿血管损伤中心肌素与miR-145的表达情况及其临床意义研究[J].中国全科医学,2016,19(31):3831-3836.
[12] Wang Z,Wang Y,Zhu R,et al. Long-term survival and death causes of systemic lupus erythematosus in China:a systemic review of observational studies[J]. Medicine(Baltimore),2015,94(17):e794.
[13]彭家清.尿酸和血清胱抑素C对高血压肾损害早期诊断的预测价值[J].浙江临床医学,2014,16(5):705-707.
[14] Hsieh Y P,Chang C C,Yang Y. et al. The role of uric acid in chronic kidney disease patients[J]Nephrology(Carlton),2017,22(6):441-448.
[15] Chang Y H,Lei C C,Lin K C,et al. Serum uric acid level as an indicator for CKD regression and progression in patients with type 2 diabetes mellitus-a 4. 6-year cohort study[J]. Diabetes Metab Res Rev,2016,32(6):557-564.