SERUM COMPLEMENT VALUES (C-3 AND C-4) TO DIFFERENTIATE BETWEEN SYSTEMIC LUPUS ACTIVITY AND PREECLAMPSIA
SERUM COMPLEMENT VALUES (C-3 AND C-4) TO DIFFERENTIATE BETWEEN SYSTEMIC LUPUS ACTIVITY AND PREECLAMPSIA
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DOI：
10.1016/0002-9343(86)90251-2
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发表时间：
1986-08-01
影响因子：
5.9
通讯作者：
WEISSMANN, G
中科院分区：
文献类型：
--
作者：
BUYON, JP;CRONSTEIN, BN;WEISSMANN, G
通常很难区分 SLE 患者的系统性红斑狼疮 (SLE) 恶化和并发先兆子痫，因为这两种疾病的表现都包括蛋白尿和高血压。本研究旨在确定血清 C3 和 C4 值是否有助于区分 SLE 活动性和先兆子痫。在 21 名未怀孕的育龄妇女中，平均 C3 水平为 124 .+-。 5 mg/dl，平均 C4 为 31±。 1毫克/分升。在 24 名妊娠晚期的正常女性中，C3 和 C4 水平升高（与非妊娠对照女性相比，分别为 165 .+-. 4 mg/dl，p < 0.001；与非妊娠对照女性相比，分别为 37 .+-. 2 mg/dl，p < 0.01）。在 17 名妊娠晚期患有先兆子痫的女性中，平均 C3 水平为 162 .+-。 4 mg/dl，与正常孕妇没有差异（与非怀孕对照女性相比，p < 0.001；与正常孕妇相比，p = NS），平均 C4 为 29 .+-。 3 mg/dl，低于正常孕妇的水平（与正常孕妇相比，p < 0.02）。所有这些先兆子痫患者中均不存在滴度低于 1:20 的抗核抗体。相比之下，患有 SLE 的孕妇在妊娠晚期的 C3 (103 .+-. 13 mg/dl) 和 C4 (15.3 .+-. 3.6 mg/dl) 值显着低于正常孕妇（C3 和 C4 p < 0.001）或先兆子痫女性（C3 p < 0.001，C4 p < 0.004）。怀孕三个月。在确定了连续补体值的 8 名 SLE 女性中，3 名 C3 或 C4 水平下降，并且每名女性在怀孕期间或怀孕后立即出现 SLE 活动。 C3 浓度升高的 5 名患者均未出现疾病活动；然而，其中一名患者出现了先兆子痫，其特征是高血压和蛋白尿。因此，血清 C3 和 C4 的测量有助于区分 SLE 活动性和先兆子痫，因为 SLE 女性的 C3 和 C4 均显着低于先兆子痫女性，并且 SLE 女性在无并发症或先兆子痫妊娠期间血清 C3 和 C4 浓度升高。
It is often difficult to differentiate between an exacerbation of systemic lupus erythematosus (SLE) and intercurrent pre-eclampsia in a patient with SLE since the manifestations of both entities include proteinuria and hypertension. This study was undertaken to determine whether serum C3 and C4 values can help distinguish SLE activity from pre-eclampsia. In 21 nonpregnant women of child-bearing age, the mean C3 level was 124 .+-. 5 mg/dl and the mean C4 was 31 .+-. 1 mg/dl. In 24 normal women in the third trimester of pregnancy, the C3 and C4 levels were elevated (165 .+-. 4 mg/dl, p < 0.001 versus nonpregnant control women; 37 .+-. 2 mg/dl, p < 0.01 versus nonpregnant control women, respectively). In 17 women in the third trimester of pregnancy with documented pre-eclampsia, the mean C3 level was 162 .+-. 4 mg/dl, no different from that in normal pregnant women (p < 0.001 versus nonpregnant control women; p = NS versus normal pregnant women), and the mean C4 was 29 .+-. 3 mg/dl, lower than that found in normal pregnant women (p < 0.02 versus normal pregnant women). Antinuclear antibody was absent at titers of less than 1:20 in all of these preeclamptic patients. In contrast, pregnant women with SLE had significantly lower C3 (103 .+-. 13 mg/dl) and C4 (15.3 .+-. 3.6 mg/dl) values during the third trimester of pregnancy than either normal pregnant women (p < 0.001 for C3 and C4) or women with pre-eclampsia (p < 0.001 for C3 and p < 0.004 for C4) during the third trimester of pregnancy. Of the eight women with SLE in whom serial complement values were determined, three had falling C3 or C4 levels, and in each, there was a flare of SLE activity either during or immediately after pregnancy. None of the five patients with a rising C3 concentration had a flare of disease activity; however, pre-eclampsia developed in one of these patients, characterized by hypertension and proteinuria. Thus, measurement of serum C3 and C4 can help differentiate between SLE activity and pre-eclampsia, since both C3 and C4 are significantly lower in women with SLE than women with pre-eclampsia, and serum C3 and C4 concentrations rise during uncomplicated or pre-eclamptic pregnancy in women with SLE.