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目的探讨抗内皮细胞抗体在狼疮性肾炎临床和病理改变中的意义。方法采用细胞酶联免疫吸附实验(ELISA),对58例狼疮性肾炎病人血清进行抗内皮细胞抗体检测,并以提取的内皮细胞蛋白为抗原,应用免疫印迹方法对抗内皮细胞抗体的抗原进行了分析。结果在58例狼疮性肾炎病人中抗内皮细胞抗体的阳性率为36%,抗内皮细胞抗体阳性病人具有血小板减少发生率增高(24%),血清IgG水平增高(13±7)g/L,C3水平降低以及抗核抗体谱中多种抗体阳性率增高倾向。抗内皮细胞抗体可识别内皮细胞分子量12000~90000的多种蛋白成分,在伴有大量蛋白尿的狼疮性肾炎病人中,同时与内皮细胞分子量27000,29000抗原相结合抗体的阳性率(34%)明显高于非大量蛋白尿的病人(4%)(P<0.05);在肾小球微血栓检出阳性的狼疮性肾炎病人中,与内皮细胞29000抗原相结合抗体的阳性率(60%)明显高于未检出肾小球微血栓的病人(14%)。结论抗内皮细胞抗体阳性狼疮性肾炎病人,常伴有较严重的自身免疫紊乱;与内皮细胞某些抗原成分相结合的抗体在狼疮性肾炎临床和病理改变中可能具有一定的意义
Objective To investigate the significance of anti-endothelial cell antibodies in clinical and pathological changes of lupus nephritis. Methods The anti-endothelial cell antibodies of 58 patients with lupus nephritis were detected by enzyme-linked immunosorbent assay (ELISA). The anti-endothelial cell antigens were analyzed by immunoblotting using the extracted endothelial cell protein as antigen . Results In 58 patients with lupus nephritis, the positive rate of anti-endothelial antibody was 36%, the anti-endothelial cell antibody positive patients had thrombocytopenia (24%) and serum IgG increased (13 ± 7) g / L, C3 levels and antinuclear antibody spectrum decreased the positive rate of multiple antibodies tends to increase. Anti-endothelial cell antibodies can recognize a variety of protein components with a molecular weight of 12000-90000 in endothelial cells. In the lupus nephritis patients with large amounts of proteinuria, antibodies against both endothelial cells with molecular weights of 27000 and 29000 were also positive (34%), (4%) (P <0.05). In the patients with positive glomerulonephritis, the positive rate of antibody binding to 29000 antigen in endothelial cells was %) Was significantly higher than those who did not detect glomerular micro-thrombus (14%). Conclusion Anti-endothelial cell antibody-positive patients with lupus nephritis often have severe autoimmune disorders. Antibodies that bind to certain antigenic components of endothelial cells may play a role in the clinical and pathological changes of lupus nephritis