PREDICTIVE VALUE OF COMPLEMENT PROFILES AND ANTI-DSDNA IN SYSTEMIC LUPUS-ERYTHEMATOSUS
PREDICTIVE VALUE OF COMPLEMENT PROFILES AND ANTI-DSDNA IN SYSTEMIC LUPUS-ERYTHEMATOSUS
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DOI：
10.1136/ard.45.5.359
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发表时间：
1986-05-01
影响因子：
27.4
通讯作者：
BRONSVELD, W
中科院分区：
文献类型：
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作者：
SWAAK, AJG;GROENWOLD, J;BRONSVELD, W
对143例系统性红斑狼疮（SLE）患者进行了前瞻性研究，研究了临床加重、抗dsDNA水平和血清补体成分C1q、C4、C3、C5和C9水平之间的关系。在这143例患者中，有33例发生了严重的临床疾病加重。抗dsDNA水平与疾病活动性的关系的评估证实了我们早期的发现，即抗dsDNA水平在严重恶化之前上升，在严重恶化之后下降。在其余的110例SLE患者中，抗dsDNA水平几乎恒定，但这些患者都没有经历过严重恶化。在21例发生肾功能恶化的SLE患者中，首先观察到C4下降，随后是Clq和C3水平下降，开始于肾脏受累的第一个迹象之前约25至20周。在12例SLE患者中，观察到补体成分C4、C1q和C3的不一致分布，这些患者发生了急性加重而没有肾脏受累。C5水平几乎不受影响，而C9水平在急性加重期间通常高于正常水平，与急性加重类型无关。这些结果表明，通过遵循补体和抗dsDNA谱，不仅可以预测恶化，而且可以在恶化的第一个临床体征出现之前获得关于疾病模式的指针。
In a prospective study of 143 patients with systemic lupus erythematosus (SLE) the relation between clinical exacerbations, anti-dsDNA levels, and serum levels of complement components, C1q, C4, C3, C5 and C9 was investigated. In 33 out of these 143 patients a major clinical exacerbation of the disease developed. Evaluation of anti-dsDNA levels in relation to disease activity confirmed our earlier finding that anti-dsDNA levels rose before a major exacerbation and decreased after it. In the remaining 110 SLE patients a nearly constant anti-dsDNA level was seen, but none of these patients experienced a major exacerbation. In the 21 SLE patients who developed deterioration in renal function a decrease of C4 followed by decreases of Clq and C3 levels was seen first, starting about 25 to 20 weeks before the first signs of renal involvement. In the 12 SLE patients who developed an exacerbation without renal involvement an inconsistent profile of the complements components C4, Clq, and C3 was observed. C5 levels were hardly affected at all, while C9 levels were in general higher than normal during the exacerbation, irrespective of the type of exacerbation. These results show that, by following the complement and anti-dsDNA profiles, not only can exacerbations by predicted but also a pointer can be obtained about the pattern of disease well before the first clinical signs of an exacerbation appear.