The Clinical Value Of Anti-neutrophil Cytoplasmic Antibody In Systemic Lupus Erythematosus

Objective: To retrospectively analyze the positive rate of ANCA antibody in sera of patients with Systemic lupus erytheosus(SLE)and the influence of ANCA positive on disease activity and clinical characteristics of SLE,and to explore the correlation between ANCA positive and SLE patients,so as to provide guidance for future clinical work.Method: The clinical data of 327 SLE patients admitted to the Department of Rheumatology and Immunology of the First Affiliated Hospital of Dali University from January 2018 to June 2022 were retrospectively analyzed.According to whether pANCA was positive(excluding MPO and PR3 positive),SLE patients were divided into pANCA positive group SLE and pANCA negative group SLE.The basic data,clinical symptoms,systemic damage,renal pathology and laboratory indicators were analyzed.Two independent sample t test,nonparametric rank sum test,chi-square test,continuity correction and Fisher ’s exact probability method were used to describe and analyze the above baseline data.P < 0.05 was considered statistically significant.Results :1.Among the 327 SLE patients,224 pANCA positive SLE patients were detected,and the positive rate of pANCA was 68.5 %.The SLEDAI score of SLE patients in pANCA positive group was higher than that in negative group(P < 0.05).2.Clinical manifestations : There was no significant difference in rash,alopecia,painless oral ulcer,photoallergy and Raynaud ’s phenomenon between the two groups(P > 0.05).The levels of creatinine and 24 h urine protein in pANCA positive group were higher than those in pANCA negative group(P < 0.05).There were significant differences in anemia,leukopenia,two-line and three-line reduction between the two groups(P < 0.05).In the respiratory system involvement,the difference in pulmonary hypertension between the two groups was statistically significant(P < 0.05).There was no significant difference in gastrointestinal,cardiovascular and central nervous system damage between the two groups(P > 0.05).3.Renal pathological findings : 220 cases in this group showed LN,of which 37 patients underwent renal biopsy,the results were 11 cases(29.3 %)of type IV + V,10cases(27.03 %)of type IV,8 cases(21.62 %)of type V,3 cases(8.1 %)of type III,3 cases(8.1 %)of type III + IV,2 cases(5.4 %)of type II,the proportion of type V in pANCA negative group was higher than that in pANCA positive group(35.7 % ∶13 %).4.The positive rate of anti-ds DNA,Ig G and PLR levels in the pANCA positive group were higher than those in the negative group,and the levels of complement C3 and C4 were lower than those in the negative group,the differences were statistically significant(P < 0.05).There was no significant difference in ANA antibody,anti-SM antibody,ESR,CRP and NLR(P > 0.05).Conclusion :1.The SLEDAI score of pANCA positive SLE patients was significantly higher than that of negative group.It is suggested that pANCA positive is associated with disease activity in SLE patients;2.The blood system damage and lupus nephritis are more common in pANCA positive SLE patients,and the creatinine and 24 h urine protein are higher,and the renal damage is more serious;it is suggested that pANCA may have certain predictive value for renal damage and blood system damage in patients with lupus.