摘要
目的检测系统性红斑狼疮(SLE)患者血浆血管性血友病因子(VWF)水平及VWF裂解酶(VWF-CP)活性,探讨VWF及VWF-CP在SLE中的临床意义。方法采用残余胶原结合实验法及ELISA法分别对30例SLE患者血浆VWF-CP活性及VWF:AG水平进行检测。结果SLE患者血浆VWF:AG(114.6±16.3)%显著高于正常对照组(71.3±49.5)%(P<0.01),而血浆VWF-CP活性水平(57.7±16.3)%显著低于正常对照组(86.6±1.8)%(P<0.01),狼疮性肾炎(LN)组(130.1±40.6)%血浆VWF:AG水平显著高于非LN组(97.6±27.6)%(P<0.05),而VWF-CP活性显著降低(P<0.05),血浆VWF-CP活性水平与狼疮活动指数(SLEDAI)呈负相关(R=-0.4316,P<0.05)。18例肾活检的LN患者中,Ⅳ型VWF水平最高,VWF-CP活性最低,其余3型之间无差别。30例初发SLE患者综合治疗4周后血浆VWF:AG水平显著下降,VWF-CP活性水平在治疗后SLEDAI评分≥9分者,无显著性升高,SLEDAI评分<9分者,有显著性升高(P<0.05)。结论SLE的血浆VWF升高,VWF-CP活性低下,参与SLE尤其是LN的发生发展,内皮损伤和自身抗体可能是致SLE患者VWF升高,VWF-CP活性低下的原因。
Objective To evaluate the clinical significance of plasma yon Willebrand factor（vWF） and yon Willebrand factor-cleaving protease （vWF-CP） activity in systemic lupus erythematosus （ SLE ）. Methods vWF antigen（vWF：Ag） and vWF-CP activity were respectively evaluated by using ELISA and residual-collagen binding assay（ R-CBA ） in 30 patients with SLE and 40 normal controls. Results The level of the vWF： Ag in SLE patients （114. 6 ± 16. 3 ）% was significanfly higher than that in the normal controls（71.3 ±49. 5）% （P 〈0.01） , while the level of plasma vWF-CP activity in the SLE patients（57.7 ± 16. 3 ） % was significantly lower than that in the conrols （ 86. 6 ± 1.8 ） % （ P 〈 0. 01 ）. The level of vWF- CP activity was positively correlated with SLE disease activity index（SLEDAI）. The alterations of these two indices were remarkable in lupus nephritis （LN） patients in comparison with those in non-LN patients. The level of vWF-CP activity in type IV LN was lowest among the four types of LN （ Ⅱ , Ⅲ, Ⅳ, Ⅴ ）. The level of the vWF： Ag in 30 SLE patients was reduced four weeks after therapy, on the other hand, the vWF-CP activity was significantly increased in those with SLEDAI below 9, but unchanged in whose with SLEDAI above 9. Conclusions The injury of endothelial cells and to production autoantibodies against vWF-CP were the factors that resulted in lower vWF-CP activity in SLE patients and this lowered activity may influence the progression of SLE.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2006年第1期42-44,共3页
Chinese Journal of Internal Medicine
基金
国家自然科学基金资助项目(30470732)
