| Object: To explore the different serum indicators alone and combined detection in the diagnosis of lupus nephritis,to determine the significance of disease activity and pathological classification for clinical diagnosis and treatment of lupus nephritis to provide serological basis.Methods: In September 2015-2016 year in August in the Department of Rheumatology in People 's Hospital of Xinjiang Uygur Autonomous Region of newly diagnosed lupus nephritis patients with 50 cases of the observation group,the same period of systemic lupus erythematosus(not involving renal)50 patients were in control group,and 50 healthy volunteers as normal control group.The levels of serumcomplement C1q(C1q),complement C3(C3),complement C4(C4),immunoglobulin Ig G(Ig G)were detected by using ELISA technique,and serum anti-C1 q antibody(C1q Ab),anti-nucleosome antibody(Anu A)levels were detected by using turbidimetric inhibition immuno assay.The value of different serum indexes to diagnose lupus nephritis was assessed by receiver operating characteristic curve(ROC),the differences were analyzed by t test,and the difference was statistically significant between P<0.05.Results: 1.The levels of C1q(118.00 ± 30.50mg/L),C3(0.775 ± 0.182g/L)and C4(0.070 ± 0.013g/L)were lower and their positive rates(81.25%,70.0%,83.75%)were higher in observational group than those in case control group and healthy control group(P<0.05);The levels of Ig G(22.11 ± 4.87g/L),C1 q Ab(89.30 ± 20.34Au/ml)and Anu A(76.85±18.34Ru/ml)as well as their positive rates(76.25%,87.50%,90.00%)were higher in observational group than those in case control group and healthy control group(P<0.05).The positive rate of anti-SSB antibody in the observation group and the case control group was significantly higher than that in the healthy control group(48.75%,43.33% vs0.00%,P <0.05),but there was no significant difference between the two groups(P> 0.05)The AUC of serum C1 q,C3,C4,Ig G,C1 q Ab and Anu A were 0.819,0.705,0.742,0.702,0.851 and 0.894,the area under the curve(AUC)of joint detection of C1 q,C4,Ig G,C1 q Ab and Anu A was 0.997.2.Among the 80 patients with LN,28 were stable disease,the AI score was 5.03 ± 5.87 in the disease stable group,52 cases were disease activity,the AI score of the disease activity group was 14.32 ± 4.56,The level of serum C1 q in the disease activity group was significantly lower than that in the stable group(107.05 ± 28.34 vs 38.21 ± 57.45 mg / L,P <0.05),Serum levels of C1 q Ab and Anu A were significantly higher in the disease-stable group than in the stable group(109.21 ± 17.23vs52.33 ± 22.98 Au / ml,84.64 ± 28.35vs62.38 ± 34.32 Ru / ml,P <0.05),There was no significant difference in the positive rates of serum C3,C4,Ig G and anti-SSB antibodies between the stable group and the disease group(P> 0.05).The complement C1 q,C1q Ab and Anu A were sensitive to the activity of LN disease The degree and specificity were 82.69%,89.29%,92.30%,85.71%,86.54%,57.14%,There was a significant positive correlation between serum C1 q level and AI index(r =-0.638,P <0.01).Serum C1 q Ab level was positively correlated with AI index(r = 0.839,P <0.01).3.Among the 80 patients with LN,22 were type ? patients,4 were type ?,37 had type ?,and 17 had type ?,The level of C1 q expression in LN was the lowest(134.46 ± 39.64 mg / L),which was significantly lower than that of the other two types(P <0.01),There was no significant difference between type ? and type ?(P> 0.05),(0.842 ± 0.129 g / L,P <0.01),? type and ? type LN(P> 0.05)which was significantly higher than that of type ? and ? type LN,The expression level of C1 q Ab in type ? LN was the highest(102.01 ± 8.66,P <0.01),and there was no significant difference between type ? and type ?(P> 0.05),The positive rate of anti-SSB antibody expression was as follows: type ?> ? type> type ?(68.18%> 52.94%> 40.54%).Conclusion: 1.complement C1 q,C3,C4,Ig G,C1 q Ab and Anu A are associated with lupus nephritis,joint detection can significantly improve the diagnostic efficiency.2.C1 q was negatively correlated with renal pathological activity index,C1 q Ab was positively correlated with renal pathological activity index,and could be inferred from C1 q and C1 q Ab concentration.3.The expression level of C1 q,C3,C1 q Ab and anti-SSB antibody in type II,type I? and ? LN have obvious difference,can through the detection of serum C1 q,C3,C1 q Ab and the concentration of anti-SSB antibody to type II,type I? and ? LN differential diagnosis. |
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