狼疮性肾炎患者血清铁调素水平的变化

发布时间：2018-03-06 11:22

本文选题：狼疮性肾炎　切入点：铁调素　出处：《川北医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:狼疮性肾炎(Lupus Nephritis LN)是系统性红斑狼疮(Systemic Lupus Erythematosus SLE)累及肾脏所引起的一种免疫复合物性肾炎,免疫复合物的形成引起大量炎症因子及炎症介质的释放,共同参与了LN疾病的发生发展。研究发现,铁调素是体内受炎症因子调控的一种铁代谢调节因子,也是一个参与炎性疾病发展过程的重要炎症因子。铁调素与类风湿性关节炎、炎症性肠病等自身免疫性疾病均存在一定关系。本研究旨在观察LN患者血清铁调素水平的变化,并分析其与相关临床指标的关系,初步探讨铁调素在LN疾病发生发展中的作用机制及其临床意义。方法:选取62例LN患者作为实验组,其中女性56例,男性6例,平均年龄(32.13±5.85)岁。根据系统性红斑狼疮疾病活动指数(Systemic Lupus Erythematosus Disease Activity Index SLEDAI)评分将LN患者分为:活动期LN组42例(评分≥10分)、稳定期LN组20例(评分10分)。另选取30例健康体检者作为对照组,性别及年龄与实验组均相匹配。收集所有入选者的血液标本及临床相关资料。血清铁调素的水平通过酶联免疫吸附法(Enzyme-linked Immunosorbent Assay ELISA)检测获得。比较各组间血清铁调素水平的差异,同时分析其与抗ds-DNA抗体、SLEDAI评分、补体C3、补体C4、抗c1q抗体等临床指标的相关性,采用spss13.0统计软件进行数据统计分析,p0.05表示差异有统计学意义。结果:l.LN实验组血清铁调素水平明显高于健康对照组(p0.01);活动期LN组血清铁调素水平高于稳定期LN组和健康对照组(p0.01);稳定期LN组血清铁调素水平高于健康对照组,但两组间差异无统计学意义(p0.05);2.LN实验组血红蛋白水平显著低于健康对照组(p0.01);活动期LN组血红蛋白水平明显低于稳定期LN组和健康对照组(p0.01);稳定期LN组血红蛋白水平与健康对照组相比,差异无统计学意义(p0.05);3.LN患者血清铁调素水平与抗ds-DNA抗体、抗c1q抗体、SLEDAI评分、超敏C反应蛋白(hs-CRP)呈正相关(p0.01或p0.05);与补体C3呈负相关(p0.05);与血沉(ESR)、补体C4、血红蛋白均无相关性(p0.05)。结论:铁调素可能在LN疾病发生发展过程中发挥重要作用。LN患者血清铁调素水平的变化在一定程度上可以反应狼疮活跃,对指导临床治疗、评估疗效及预后可能具有重要的意义。
[Abstract]:Objective: lupus Nephritis (LN) is a kind of immune complex glomerulonephritis caused by systemic Lupus Erythematosus SLEs involving the kidneys. The formation of immune complex causes the release of a large number of inflammatory factors and inflammatory mediators. It is found that iron modulin is a kind of iron metabolism regulator regulated by inflammatory factors in the body, and it is also an important inflammatory factor involved in the development of inflammatory disease. Iron modulin and rheumatoid arthritis are involved in the development of LN disease. The aim of this study was to observe the changes of serum iron modulin levels in patients with LN and to analyze the relationship between them and related clinical indexes. To explore the mechanism and clinical significance of iron modulin in the pathogenesis and development of LN. Methods: 62 patients with LN were selected as experimental group, including 56 females and 6 males. The mean age was 32.13 卤5.85 years. According to systemic Lupus Erythematosus Disease Activity Index SLEDAI, LN patients were divided into active LN group (n = 42) and stable LN group (n = 20) (n = 30). The healthy persons were used as the control group. The blood samples and clinical data of all the subjects were collected. The serum iron levels were detected by Enzyme-linked Immunosorbent Assay Elisa. At the same time, we analyzed the correlation with the clinical indexes such as ds-DNA antibody score, complement C3, complement C4, anti-c1q antibody, and so on. Spss13.0 statistical software was used to analyze the data. Results there was a significant difference between the two groups. Results the serum iron modulin levels in the experimental group were significantly higher than those in the healthy control group (p 0.01), and the levels of iron modulin in the active LN group were higher than those in the stable LN group and in the stable LN group. The serum iron modulin level in LN group was higher than that in healthy control group. However, there was no significant difference between the two groups. 2. The hemoglobin level in the LN group was significantly lower than that in the healthy control group, the hemoglobin level in the active LN group was significantly lower than that in the stable LN group and the healthy control group, and the hemoglobin level in the LN group was significantly lower than that in the stable LN group. Compared with the healthy control group, There was no significant difference in serum iron modulin level and anti ds-DNA antibody, anti c1q antibody and SLEDAI score in LN patients. Hypersensitive C-reactive protein hs-CRP was positively correlated with p0.01 or p0.05a; negatively correlated with complement C3 (p0.05); and not with ESR, complement C4, hemoglobin. Conclusion: iron may play an important role in the pathogenesis and development of LN. To some extent, the change of iron modulin level can reflect the active lupus. It may be of great significance in guiding clinical treatment and evaluating curative effect and prognosis.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R593.242

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