狼疮性肾炎患者血清和尿液中IL-32和KIM-1的表达水平及临床意义
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摘要
目的探讨狼疮性肾炎患者血清和尿液中白细胞介素-32(IL-32)和肾损伤分子1抗体(KIM-1)的表达水平及临床意义。方法选择狼疮性肾炎(LN)患者166例,分为非活动期LN组86例,活动期LN组80例,选择同期门诊正常体检者70例为对照组;测定3组血清和尿液中IL-32和KIM-1水平。结果非活动期LN组、活动期LN组血清和尿液IL-32、KIM-1水平高于对照组,活动期LN组血清和尿液IL-32、KIM-1水平高于非活动期LN组(t=12. 45、15. 37、15. 87、14. 96、13. 06、15. 43、14. 95、17. 15,P <0. 05);非活动期LN组、活动期LN组血清BUN、Crea水平高于对照组,C3、C4水平低于对照组;活动期LN组血清BUN、Crea水平高于非活动期LN组,C3、C4水平低于非活动期LN组(t=14. 21、17. 54、15. 45、17. 76、10. 76、12. 23、13. 56、14. 43,P <0. 05);非活动期LN组、活动期LN组血清ESR、Proteinuria、SLEDAI、水平高于对照组,活动期LN组血清ESR、Proteinuria、SLEDAI水平高于非活动期LN组(t=13. 87、15. 35、17. 54、18. 12、19. 09、13. 23,P <0. 05);血清和尿液IL-32和KIM-1水平与BUN、Crea、ESR、Proteinuria、RSLEDAI正相关关系明显,与C3、C4负相关关系明显(P <0. 05);尿液IL-32、血清IL-32、尿液KIM-1、血清KIM-1、Proteinuria均为LN患者处于活动期的危险因素(OR=17. 89、4. 26、5. 02、2. 43、13. 62,P <0. 05)。结论 LN患者血清和尿液中IL-32和KIM-1的表达水平升高,其与BUN、Crea、ESR、Proteinuria、C3、C4、SLEDAI相关关系明显;尿液和血清IL-32、KIM-1及Proteinuria均为LN患者处于活动期的危险因素。
Objective To investigate the expression and clinical significance of IL-32 and KIM-1 in serum and urine of patients with lupus nephritis( LN). Methods A total of 166 patients with LN who were treated in our hospital were divided into inactive LN group( n = 86) and active LN group( n = 80),moreover,the other 70 healthy subjects who underwent physical examination at the same period were enrolled as control group. The levels of IL-32 and KIM-1 were detected and compared among the three groups. Results The levels of IL-32 and KIM-1 in serum and urine in inactive LN group and active LN group were significantly higher than those in control group,and which in active LN group were significantly higher than those in inactive LN group( P < 0. 05). The serum levels of BUN and Crea in inactive LN group and active LN group were significantly higher than those in control group,however,the serum levels of C3,C4 were significantly lower than those in control group. Moreover the serum levels of BUN and Crea in active LN group were significantly higher than those in inactive LN group,but the levels of C3 and C4 in active LN group were significantly lower than those in inactive LN group( P < 0. 05).In addition the serum levels of ESR,proteinuria,SLEDAI in inactive LN group and active LN group were significantly higher than those in control group,which in active LN group were significantly higher than those in active LN group( P < 0. 05).Besides the levels of IL-32 and KIM-1 in serum and urine were positively correlated with those of BUN,Crea,ESR,proteinuria and RSLEDAI,however,which were negative correlated with those of C3 and C4( P < 0. 05). Furthermore of the urine IL-32,serum IL-32,urine KIM-1,serum KIM-1 and proteinuria were the risk factors in patients with active lupus nephritis( OR =17. 89,4. 26,5. 02,2. 43,13. 62,P < 0. 05). Conclusion The expression levels of IL-32 and KIM-1 in serum and urine in patients with lupus nephritis are increased obviously,which are correlated with BUN,Crea,ESR,proteinuria,C3,C4,SLEDAI. Moreover urine IL-32,serum IL-32,urine KIM-1,serum KIM-1 and proteinuria are the risk factors in patients with active lupus nephritis.
Objective To investigate the expression and clinical significance of IL-32 and KIM-1 in serum and urine of patients with lupus nephritis( LN). Methods A total of 166 patients with LN who were treated in our hospital were divided into inactive LN group( n = 86) and active LN group( n = 80),moreover,the other 70 healthy subjects who underwent physical examination at the same period were enrolled as control group. The levels of IL-32 and KIM-1 were detected and compared among the three groups. Results The levels of IL-32 and KIM-1 in serum and urine in inactive LN group and active LN group were significantly higher than those in control group,and which in active LN group were significantly higher than those in inactive LN group( P < 0. 05). The serum levels of BUN and Crea in inactive LN group and active LN group were significantly higher than those in control group,however,the serum levels of C3,C4 were significantly lower than those in control group. Moreover the serum levels of BUN and Crea in active LN group were significantly higher than those in inactive LN group,but the levels of C3 and C4 in active LN group were significantly lower than those in inactive LN group( P < 0. 05).In addition the serum levels of ESR,proteinuria,SLEDAI in inactive LN group and active LN group were significantly higher than those in control group,which in active LN group were significantly higher than those in active LN group( P < 0. 05).Besides the levels of IL-32 and KIM-1 in serum and urine were positively correlated with those of BUN,Crea,ESR,proteinuria and RSLEDAI,however,which were negative correlated with those of C3 and C4( P < 0. 05). Furthermore of the urine IL-32,serum IL-32,urine KIM-1,serum KIM-1 and proteinuria were the risk factors in patients with active lupus nephritis( OR =17. 89,4. 26,5. 02,2. 43,13. 62,P < 0. 05). Conclusion The expression levels of IL-32 and KIM-1 in serum and urine in patients with lupus nephritis are increased obviously,which are correlated with BUN,Crea,ESR,proteinuria,C3,C4,SLEDAI. Moreover urine IL-32,serum IL-32,urine KIM-1,serum KIM-1 and proteinuria are the risk factors in patients with active lupus nephritis.
引文
1罗珊珊,刘文礼.狼疮性肾炎中医辨证分型与实验室检查相关性分析.中医学报,2017,32:139-141.
2 Xie Y,Wang Q,Wang C,et al.Association between the levels of urine kidney injury molecule-1 and the progression of acute kidney injury in the elderly.Plos One,2017,12:1076-1078.
3程玉婷,张雅兰,吴垚,等.狼疮性肾炎的中西医结合治疗进展.中国中西医结合肾病杂志,2017,18:278-280.
4 Ceeraz S,Sergent PA,Plummer SF,et al.VISTA deficiency accelerates the development of fatal murine lupus nephritis.Arthritis&Rheumatology,2017,69:814-815.
5 Moroni G,Ponticelli C.Synthetic pharmacotherapy for lupus nephritis.Expert Opinion on Pharmacotherapy,2017,18:175-177.
6谭玲玲,黄梅,樊均明.狼疮性肾炎患者血清对HK-2细胞TGF-β、P-smad3表达的影响及意义.广东医学,2017,8:3277-3279.(下转页)
7 Naicker T,Etounalli S,Moodley J.Kidney injury molecule-1,Calbindin,Interleukin-18 and Monocyte chemoattractant protein-1 in HIV associated pre-eclampsia.Placenta,2017,57:275-276.
8中华医学会风湿病学分会.系统性红斑狼疮诊治指南(草案).中华风湿病学杂志,2003,7:508-513.
9 Hahn BH,Mc Mahon MA,Wilkinson A,et al.American College of Rheumatology guidelines forscreening,treatment,and management of lupusnephritis.Arthritis Care Res(Hoboken),2012,64:797-808.
10中华医学会风湿病学分会.系统性红斑狼疮诊断及治疗指南.中华风湿病学杂志,2010,14:342-346.
11王坤,贾兴旺,颜光涛.红细胞分布宽度和D-二聚体联合评估系统性红斑狼疮病情活动程度.标记免疫分析与临床,2017,24:130-132.
12 Hong JT,Son DJ,Lee CK,et al.Interleukin 32,inflammation and cancer.Pharmacology&Therapeutics,2017,174:127.
13 Bland SK,Schmiedt CW,Clark ME,et al.Expression of Kidney Injury Molecule-1 in Healthy and Diseased Feline Kidney Tissue.Veterinary Pathology,2017,54:213-214.
14付豆,丁国华,王惠明,等.血尿酸水平与系统性红斑狼疮活动度及其肾损害的关系.山东医药,2017,57:43-45.
15 Olvera-Posada D,Pautler S,Sener A,et al.PD12-10 kidney injury molecule-1 as a potential urinary biomarker of hydroneprosis may not be affected by inflammatory causes in the urinary tract.Journal of Urology,2017,197:269-270.
16 Schoenfeld MR,Messeloff CR.Cardiac tamponade in systemic lupus erythematosus.Circulation,2017,27:98-99.
17赵莉莉,熊佩华.中西医结合治疗狼疮性肾炎的系统评价.中国中西医结合肾病杂志,2017,18:41-44.
18 Zhang Y,Li A,Wen J,et al.Kidney Injury Molecule-1 Level is Associated with the Severity of Renal Interstitial Injury and Prognosis in Adult Henoch-Schnlein Purpura Nephritis.Archives of Medical Research,2017,48:45-47.(:)
2 Xie Y,Wang Q,Wang C,et al.Association between the levels of urine kidney injury molecule-1 and the progression of acute kidney injury in the elderly.Plos One,2017,12:1076-1078.
3程玉婷,张雅兰,吴垚,等.狼疮性肾炎的中西医结合治疗进展.中国中西医结合肾病杂志,2017,18:278-280.
4 Ceeraz S,Sergent PA,Plummer SF,et al.VISTA deficiency accelerates the development of fatal murine lupus nephritis.Arthritis&Rheumatology,2017,69:814-815.
5 Moroni G,Ponticelli C.Synthetic pharmacotherapy for lupus nephritis.Expert Opinion on Pharmacotherapy,2017,18:175-177.
6谭玲玲,黄梅,樊均明.狼疮性肾炎患者血清对HK-2细胞TGF-β、P-smad3表达的影响及意义.广东医学,2017,8:3277-3279.(下转页)
7 Naicker T,Etounalli S,Moodley J.Kidney injury molecule-1,Calbindin,Interleukin-18 and Monocyte chemoattractant protein-1 in HIV associated pre-eclampsia.Placenta,2017,57:275-276.
8中华医学会风湿病学分会.系统性红斑狼疮诊治指南(草案).中华风湿病学杂志,2003,7:508-513.
9 Hahn BH,Mc Mahon MA,Wilkinson A,et al.American College of Rheumatology guidelines forscreening,treatment,and management of lupusnephritis.Arthritis Care Res(Hoboken),2012,64:797-808.
10中华医学会风湿病学分会.系统性红斑狼疮诊断及治疗指南.中华风湿病学杂志,2010,14:342-346.
11王坤,贾兴旺,颜光涛.红细胞分布宽度和D-二聚体联合评估系统性红斑狼疮病情活动程度.标记免疫分析与临床,2017,24:130-132.
12 Hong JT,Son DJ,Lee CK,et al.Interleukin 32,inflammation and cancer.Pharmacology&Therapeutics,2017,174:127.
13 Bland SK,Schmiedt CW,Clark ME,et al.Expression of Kidney Injury Molecule-1 in Healthy and Diseased Feline Kidney Tissue.Veterinary Pathology,2017,54:213-214.
14付豆,丁国华,王惠明,等.血尿酸水平与系统性红斑狼疮活动度及其肾损害的关系.山东医药,2017,57:43-45.
15 Olvera-Posada D,Pautler S,Sener A,et al.PD12-10 kidney injury molecule-1 as a potential urinary biomarker of hydroneprosis may not be affected by inflammatory causes in the urinary tract.Journal of Urology,2017,197:269-270.
16 Schoenfeld MR,Messeloff CR.Cardiac tamponade in systemic lupus erythematosus.Circulation,2017,27:98-99.
17赵莉莉,熊佩华.中西医结合治疗狼疮性肾炎的系统评价.中国中西医结合肾病杂志,2017,18:41-44.
18 Zhang Y,Li A,Wen J,et al.Kidney Injury Molecule-1 Level is Associated with the Severity of Renal Interstitial Injury and Prognosis in Adult Henoch-Schnlein Purpura Nephritis.Archives of Medical Research,2017,48:45-47.(:)