本文選題：狼瘡性腎炎　切入點(diǎn)：鐵調(diào)素　出處：《川北醫(yī)學(xué)院》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:狼瘡性腎炎(Lupus Nephritis LN)是系統(tǒng)性紅斑狼瘡(Systemic Lupus Erythematosus SLE)累及腎臟所引起的一種免疫復(fù)合物性腎炎,免疫復(fù)合物的形成引起大量炎癥因子及炎癥介質(zhì)的釋放,共同參與了LN疾病的發(fā)生發(fā)展。研究發(fā)現(xiàn),鐵調(diào)素是體內(nèi)受炎癥因子調(diào)控的一種鐵代謝調(diào)節(jié)因子,也是一個(gè)參與炎性疾病發(fā)展過(guò)程的重要炎癥因子。鐵調(diào)素與類(lèi)風(fēng)濕性關(guān)節(jié)炎、炎癥性腸病等自身免疫性疾病均存在一定關(guān)系。本研究旨在觀察LN患者血清鐵調(diào)素水平的變化,并分析其與相關(guān)臨床指標(biāo)的關(guān)系,初步探討鐵調(diào)素在LN疾病發(fā)生發(fā)展中的作用機(jī)制及其臨床意義。方法:選取62例LN患者作為實(shí)驗(yàn)組,其中女性56例,男性6例,平均年齡(32.13±5.85)歲。根據(jù)系統(tǒng)性紅斑狼瘡疾病活動(dòng)指數(shù)(Systemic Lupus Erythematosus Disease Activity Index SLEDAI)評(píng)分將LN患者分為:活動(dòng)期LN組42例(評(píng)分≥10分)、穩(wěn)定期LN組20例(評(píng)分10分)。另選取30例健康體檢者作為對(duì)照組,性別及年齡與實(shí)驗(yàn)組均相匹配。收集所有入選者的血液標(biāo)本及臨床相關(guān)資料。血清鐵調(diào)素的水平通過(guò)酶聯(lián)免疫吸附法(Enzyme-linked Immunosorbent Assay ELISA)檢測(cè)獲得。比較各組間血清鐵調(diào)素水平的差異,同時(shí)分析其與抗ds-DNA抗體、SLEDAI評(píng)分、補(bǔ)體C3、補(bǔ)體C4、抗c1q抗體等臨床指標(biāo)的相關(guān)性,采用spss13.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)統(tǒng)計(jì)分析,p0.05表示差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:l.LN實(shí)驗(yàn)組血清鐵調(diào)素水平明顯高于健康對(duì)照組(p0.01);活動(dòng)期LN組血清鐵調(diào)素水平高于穩(wěn)定期LN組和健康對(duì)照組(p0.01);穩(wěn)定期LN組血清鐵調(diào)素水平高于健康對(duì)照組,但兩組間差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05);2.LN實(shí)驗(yàn)組血紅蛋白水平顯著低于健康對(duì)照組(p0.01);活動(dòng)期LN組血紅蛋白水平明顯低于穩(wěn)定期LN組和健康對(duì)照組(p0.01);穩(wěn)定期LN組血紅蛋白水平與健康對(duì)照組相比,差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05);3.LN患者血清鐵調(diào)素水平與抗ds-DNA抗體、抗c1q抗體、SLEDAI評(píng)分、超敏C反應(yīng)蛋白(hs-CRP)呈正相關(guān)(p0.01或p0.05);與補(bǔ)體C3呈負(fù)相關(guān)(p0.05);與血沉(ESR)、補(bǔ)體C4、血紅蛋白均無(wú)相關(guān)性(p0.05)。結(jié)論:鐵調(diào)素可能在LN疾病發(fā)生發(fā)展過(guò)程中發(fā)揮重要作用。LN患者血清鐵調(diào)素水平的變化在一定程度上可以反應(yīng)狼瘡活躍,對(duì)指導(dǎo)臨床治療、評(píng)估療效及預(yù)后可能具有重要的意義。
[Abstract]:Objective: lupus Nephritis (LN) is a kind of immune complex glomerulonephritis caused by systemic Lupus Erythematosus SLEs involving the kidneys. The formation of immune complex causes the release of a large number of inflammatory factors and inflammatory mediators. It is found that iron modulin is a kind of iron metabolism regulator regulated by inflammatory factors in the body, and it is also an important inflammatory factor involved in the development of inflammatory disease. Iron modulin and rheumatoid arthritis are involved in the development of LN disease. The aim of this study was to observe the changes of serum iron modulin levels in patients with LN and to analyze the relationship between them and related clinical indexes. To explore the mechanism and clinical significance of iron modulin in the pathogenesis and development of LN. Methods: 62 patients with LN were selected as experimental group, including 56 females and 6 males. The mean age was 32.13 鹵5.85 years. According to systemic Lupus Erythematosus Disease Activity Index SLEDAI, LN patients were divided into active LN group (n = 42) and stable LN group (n = 20) (n = 30). The healthy persons were used as the control group. The blood samples and clinical data of all the subjects were collected. The serum iron levels were detected by Enzyme-linked Immunosorbent Assay Elisa. At the same time, we analyzed the correlation with the clinical indexes such as ds-DNA antibody score, complement C3, complement C4, anti-c1q antibody, and so on. Spss13.0 statistical software was used to analyze the data. Results there was a significant difference between the two groups. Results the serum iron modulin levels in the experimental group were significantly higher than those in the healthy control group (p 0.01), and the levels of iron modulin in the active LN group were higher than those in the stable LN group and in the stable LN group. The serum iron modulin level in LN group was higher than that in healthy control group. However, there was no significant difference between the two groups. 2. The hemoglobin level in the LN group was significantly lower than that in the healthy control group, the hemoglobin level in the active LN group was significantly lower than that in the stable LN group and the healthy control group, and the hemoglobin level in the LN group was significantly lower than that in the stable LN group. Compared with the healthy control group, There was no significant difference in serum iron modulin level and anti ds-DNA antibody, anti c1q antibody and SLEDAI score in LN patients. Hypersensitive C-reactive protein hs-CRP was positively correlated with p0.01 or p0.05a; negatively correlated with complement C3 (p0.05); and not with ESR, complement C4, hemoglobin. Conclusion: iron may play an important role in the pathogenesis and development of LN. To some extent, the change of iron modulin level can reflect the active lupus. It may be of great significance in guiding clinical treatment and evaluating curative effect and prognosis.
【學(xué)位授予單位】：川北醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R593.242

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