【作者】 黄莉；

【导师】 顾美华；

【作者基本信息】 苏州大学 ， 内科学， 2010， 硕士

【摘要】 目的:探讨高迁移率族蛋白B1(HMGB1)在系统性红斑狼疮(SLE)患者血清中的表达和临床意义。方法:选择65例SLE患者,并按SLE疾病活动指数(SLEDAI)分组,其中活动组50例与非活动组15例;按照肾脏有无受累进行分组,其中狼疮肾炎(LN)组38例和SLE非肾炎组27例。25例健康人作为对照组。采用酶联免疫吸附(ELISA)法分别检测各组血清中HMGB1水平。采用统计学方法分析HMGB1水平与SLE病情活动性和狼疮肾损害之间的关系。结果:⑴SLE组血清HMGB1水平高于健康对照组(P<0.05)。⑵SLE活动组血清HMGB1水平高于非活动组(P<0.05)。⑶LN组血清HMGB1水平高于SLE非肾炎组(P<0.05)。⑷SLE血清HMGB1水平与SLEDAI评分呈正相关(P<0.05)。⑸SLE血清HMGB1水平与抗ds-DNA抗体水平呈正相关(P<0.05)。⑹SLE血清HMGB1水平与免疫指标血清C3水平呈负相关(P<0.05)。⑺LN组血清HMGB1水平与肾损害指标尿ALB、尿IgG、尿IgA、尿IgM、尿α2-MG及24小时尿蛋白定量均呈正相关性(P<0.05)。结论:血清HMGB1水平在SLE组高于健康对照组,活动组高于非活动组,LN组高于SLE非肾炎组,SLE血清HMGB1水平与抗ds-DNA抗体水平正相关,提示HMGB1参与了SLE、LN疾病病理发生过程,其致炎作用可能与抗ds-DNA抗体合成有关。血清HMGB1水平与SLEDAI积分呈正相关,血清HMGB1水平能反映出疾病的活动状态,可作为SLE、LN疾病活动性指标之一。此外,患者血清HMGB1水平还可作为SLE患者肾小球损害的监测指标之一。更多还原

【Abstract】 Objective: To investigate the expression and clinical significance of serum high mobility group box1 protein(HMGB1)in patients with systemic lupus erythematosus(SLE).Method: The levels of serum HMGB1 were measured in 65 SLE Chinese patients and 25 healthy persons by the method of enzyme-linked immunosorbent assay (ELISA),65 SLE patients were divided into different groups according to the SLE disease activity index (SLEDAI) score and renal involvement :50 patients at active phase and 15 at stable stage; 38 patients with nephritis and 27 patients without nephritis. And the correlation between HMGB1 levels and SLE other disease activity parameters and renal injury was analyzed.Results:⑴The levels of serum HMGB1 in SLE patients were significantly higher than that in normal controls (P<0.05).⑵The levels of serum HMGB1 in SLE patients with active lupus were significantly higher than that of in those without active lupus(P<0.05).⑶The levels of serum HMGB1 in lupus nephritis patients were significantly higher than that of in those without lupus nephritis (P<0.05).⑷The levels of serum HMGB1 was significantly positively correlated with SLE disease activity index (SLEDAI) scores(P<0.05).⑸The levels of serum HMGB1 was positively correlated with anti ds-DNA antibody levels(P<0.05).⑹The levels of serum HMGB1 was significantly negatively correlated with C3 levels(P<0.05).⑺The levels of serum HMGB1 in lupus nephritis were positively correlated with these renal injury’s clinical indexes (including urine ALB,urine IgG,urine IgA,urine IgM,urineα2-MG) and 24 hours urine protein(24hUpro)(P<0.05).Concluions: The levels of serum HMGB1 were significantly elevated in SLE patients compared with that of in healthy person, the levels of serum HMGB1 in active SLE were higher than that in those without active lupus, and higher in LN than those without LN. The levels of serum HMGB1 was significantly correlated with anti ds-DNA antibody levels, which reveals HMGB1 participate in the pathogenesis of SLE and LN, and the way of inflammation inducing effects maybe correlated with the synthesis of anti ds-DNA antibody. Besides, the levels of serum HMGB1 are positively correlated with SLEDAI scores. HMGB1 can display the state of disease activity and it is also suggested that HMGB1 can be one of the indicator of the disease activity and renal injury in patients with SLE.更多还原