C1q在自身免疫性疾病中的临床意义

doi:10.3969/j.issn.1673-8640.2017.08.006

摘要/Abstract

摘要：

目的探讨补体（C）1q检测对自身免疫性疾病（AID）的临床意义。方法选取2014年5月–2015年9月在南昌大学第二附属医院住院的AID患者203例[自身免疫性甲状腺疾病（AITD）86例、系统性红斑狼疮（SLE）56例、类风湿性关节炎（RA）32例、其他结缔组织病29例]及体检健康者（对照组）100名,采用免疫透射比浊法检测C1q、免疫比浊法检测C反应蛋白（CRP）、间接免疫荧光法（IIF）检测抗核抗体（ANA）和抗双链DNA（ds-DNA）抗体、线性免疫印迹法（LIA）检测抗Sm抗体,并对结果进行分析。结果与对照组比较,SLE组C1q水平下降（P<0.05）,RA组C1q水平升高（P<0.05）。C1q的水平随ANA滴度升高而降低（P<0.05）。抗ds-DNA抗体（+）且抗Sm抗体（+）组C1q水平显著低于抗ds-DNA抗体（-）且抗Sm抗体（-）组（P<0.05）。 CRP的水平在AID各组中均明显升高（P<0.01）。C1q与CRP间的相关系数>0.300（P<0.05）,由二者的回归方程计算出C1q的临界值（COV）范围为167.42~198.37 mg/L。定性分析C1q与自身抗体的关系：AID ANA阳性组C1q<COV的异常率高于ANA阴性组,ANA（+）且抗ds-DNA抗体（+）组C1q<COV的异常率明显高于其他自身抗体分布模式组,ANA（+）且抗Sm抗体（+）或抗Sm抗体和抗ds-DNA抗体同时阳性的患者C1q<COV的异常率明显升高,ANA阴性组C1q>COV的异常率达67.2%。结论 AID患者C1q水平与CRP呈中度正相关,C1q异常率与某些自身抗体的分布模式、AID患者的病情相关,C1q在AID中具有一定的临床意义。

关键词: 补体 1q, 自身抗体, 自身免疫性疾病, 系统性红斑狼疮

Abstract:

Objective To evaluate the role of complement （C）1q determination for autoimmune diseases（AID）. Methods A total of 203 AID patients [86 cases of autoimmune thyroid disease（AITD）,56 cases of systemic lupus erythematosus（SLE）,32 cases of rheumatoid arthritis（RA）and 29 cases of other connective tissue diseases] and 100 healthy subjects（healthy control group）were enrolled from the Second Affiliated Hospital of Nanchang University from May 2014 to September 2015. Using transmission turbidimetry,turbidimetric immunoassay,indirect immunofluorescence（IIF）and linear immunoblot assay（LIA）,C1q, C-reactive protein（CRP）,antinuclear antibody（ANA）,anti-double-stranded DNA（ds-DNA）antibody and anti-Sm antibody were determined respectively. Results Compared with healthy control group, C1q level in SLE group was decreased（P<0.05）,and that in RA group was increased（P<0.05）. The level of C1q decreased with the increasing of ANA titer degrees（P<0.05）. The C1q levels in anti-ds-DNA antibody positive and anti-Sm antibody positive group were lower than those in anti-ds-DNA antibody negative and anti-Sm antibody negative group （P<0.05）. CRP levels in AID groups were increased（P<0.01）. The correlation coefficient between C1q and CRP was >0.300（P<0.05）. Regression equation showed that the range of cut-off values（COV）was 167.42-198.37 mg/L. For C1q and autoantibodies,the abnormal rate（C1q<COV）was higher in ANA positive group than that in ANA negative group,that in ANA positive with anti-ds-DNA positive group was higher than those of other autoantibody distribution types,and that in ANA positive with anti-Sm antibody positive or with anti-Sm and anti-ds-DNA antibodies positive increased. The abnormal rate（C1q>COV）in ANA negative group was 67.2%. Conclusions For patients with AID,C1q has moderate correlation with CRP,the abnormal rate of C1q has correlations with some autoantibody distribution types and the status of patients' illness.

Key words: Complement 1q, Autoantibodies, Autoimmune diseases, Systemic lupus erythematosus

中图分类号:

R446.62

谭立明, 丁耀东, 陈娟娟, 李华, 将永清, 万雅妮, 王丽贇, 王田. C1q在自身免疫性疾病中的临床意义[J]. 检验医学, 2017, 32(8): 686-690.

TAN Liming, DING Yaodong, CHEN Juanjuan, LI Hua, JIANG Yongqing, WAN Yani, WANG Liyun, WANG Tian. Complement 1q determination for autoimmune diseases[J]. Laboratory Medicine, 2017, 32(8): 686-690.

图/表 5

参考文献 19

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组别	例数	C1q（mg/L）	CRP （mg/L）
对照组	100	191.10±23.28	2.76±0.81^*
AITD组	86	207.80±28.09	7.05±4.53^*##
SLE组	56	170.24±39.08^#	14.68±8.59^*##
RA组	32	226.36±65.44^#	27.23±10.04^*##
其他结缔组织病组	29	210.84±50.56	17.28±8.97^*##

组别	例数	C1q（mg/L）	CRP （mg/L）
对照组	100	191.10±23.28	2.76±0.81^*
AITD组	86	207.80±28.09	7.05±4.53^*##
SLE组	56	170.24±39.08^#	14.68±8.59^*##
RA组	32	226.36±65.44^#	27.23±10.04^*##
其他结缔组织病组	29	210.84±50.56	17.28±8.97^*##

组别	例数	C1q（mg/L）	CRP（mg/L）	C1q与CRP的相关性
组别	例数	C1q（mg/L）	CRP（mg/L）	r值	P值
ANA阴性组	119	202.50±59.44	16.02±10.82^*	0.337	0.000
ANA 1:100组	21	195.29±52.99	24.87±7.32^*##	0.560	0.010
ANA 1:160组	24	193.02±51.81^#	18.95±9.24^*#	0.497	0.010
ANA 1:320组	28	182.16±53.03^##△	9.67±4.86^*##△△	0.593	0.001
ANA 1:640组	11	176.22±62.42^##△△▲	10.05±6.43^*#△△	0.632	0.020

组别	例数	C1q（mg/L）	CRP（mg/L）	C1q与CRP的相关性
组别	例数	C1q（mg/L）	CRP（mg/L）	r值	P值
ANA阴性组	119	202.50±59.44	16.02±10.82^*	0.337	0.000
ANA 1:100组	21	195.29±52.99	24.87±7.32^*##	0.560	0.010
ANA 1:160组	24	193.02±51.81^#	18.95±9.24^*#	0.497	0.010
ANA 1:320组	28	182.16±53.03^##△	9.67±4.86^*##△△	0.593	0.001
ANA 1:640组	11	176.22±62.42^##△△▲	10.05±6.43^*#△△	0.632	0.020

组别		例数	C1q（mg/L）	CRP（mg/L）
抗ds-DNA抗体	抗Sm抗体	例数	C1q（mg/L）	CRP（mg/L）
-	-	180	198.46±12.82	4.61±1.94
+	-	12	161.20±32.32^**	15.41±4.67^**
-	+	7	157.93±28.85^**	8.18±3.26^**
+	+	4	156.82±37.14^*	9.21±5.82^*