Relationship between The Level Of Anti-Double Strand DNA Antibody And Lupus Renal Diseases In Patients With Systemic Lupus Erythematosus

紅斑性狼瘡患者抗雙股DNA抗體的變化和狼瘡性腎病變的相關性

許敬暉(Ching-Hui Hsu) ； 陳明翰(Ming-Han Chen) ； 陳瑋昇(Wei-Sheng Chen) ； 賴建志(Chien-Chih Lai) ； 林孝義(Hsiao-Yi Lin)

《Formosan Journal of Rheumatology》 27卷2期 (2013/12) Pp. 51-58

https://doi.org/10.6313/FJR.2013.27(02).05

摘要

目的：此篇研究的目的為探討紅斑性狼瘡患者在長期的追蹤時，其急性腎病變或慢性腎衰竭與抗雙股DNA抗體持續追蹤數值的相關性。方法：將符合紅斑性狼瘡診斷之患者，將其分組為：血清抗雙股DNA持續陽性反應、反覆變化、以及持續陰性反應三組，比較三組間急性狼瘡性腎炎以及接受血液透析的比例差異。結果：總共257位患者納入研究討論，其中有86位患者為持續陰性反應組、46位患者為反覆變化組，而有126位患者為持續陽性組。將持續陰性組和持續陽性組以及反覆變化組比較，其狼瘡性腎炎復發有統計上顯著之差異（p＜0.001, p＜0.001）；但是，在接受血液透析的患者比例則沒有統計學上之意義（p=0.539, p=0.061）。結論：患者在其罹病過程中，若是其抗雙股DNA抗體持續處於陽性反應則其狼瘡性腎炎較易復發；此外，患者之抗雙股DNA抗體即使回到正常值，但是不能持續處於陰性反應則其狼瘡性腎炎的復發也較為頻繁。因此，臨床上需要更密集以及更多相關性的檢查來追蹤此類患者。

關鍵字

紅斑性狼瘡 ； 抗雙股DNA 抗體 ； 狼瘡性腎炎

並列摘要

Objective: The goal of this study was to investigate the development of acute lupus nephritis or end stage renal disease in patients who had persistently high or variant levels of anti-dsDNA. Methods: Patients who fulfilled the diagnostic criteria for SLE were placed into one of three groups: persistent high levels, variant levels, and persistent normal levels of anti-dsDNA. Clinical renal diseases were based on the present of acute lupus nephritis, and the development of end stage renal disease (ESRD). Results: A total of 257 patients were enrolled in the study. Among them, 86 patients never have an elevation of anti-dsDNA during the follow-up period, 46 patients had variant levels of anti-dsDNA, and 125 patients had persistently high levels of anti-dsDNA. We compared the lupus nephritis flares and ESRD between normal anti-dsDNA group with high anti-dsDNA group or variant anti-dsDNA group, and the results showed significantly statistics different in acute lupus nephritis between the comparisons (p＜ 0.001, p＜0.001 respectively). However, there were no statistics different in ESRD (p=0.539, p=0.061 respectively). Conclusion: Patients who consistently showed a high anti-dsDNA level would have higher rate of acute lupus nephritis. Besides, if their serum elevated level of anti-dsDNA could not back and consistently within normal range, these patients also have less favorable renal outcome. Therefore, more intensive follow up and aggressive medical treatments are needed for these patients.

並列關鍵字

systemic lupus erythematosus(SLE) ； anti-dsDNA ； lupus nephritis