ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2021, Vol. 30 ›› Issue (1): 37-42.DOI: 10.3969/j.issn.1006298X.2021.01.007

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轻链、重链沉积病患者血液和尿液补体活化产物的研究

  

  • 出版日期:2021-02-28 发布日期:2021-02-27

Plasma and urine complement activation products in light chain and heavy chain deposition disease

  • Online:2021-02-28 Published:2021-02-27

摘要: 目的:探索轻链沉积病(light chain deposition disease,LCDD)和重链沉积病(heavy chain deposition disease,HCDD)血液及尿液中补体活化产物的差异。
方法:ELISA法检测LCDD组、HCDD组及健康对照组的血浆及尿上清中补体因子水平。
结果:HCDD组血浆C3[067(030,100)g/L vs 082(052,167)g/L,P<005)]和C1q水平明显低于LCDD组[2134(026,4400)μg/ml vs 6306(632,56666)μg/ml,P<005]。尿上清中,HCDD组C1q、Bb、C3a、C5a和sC5b9水平明显高于LCDD组。血浆 C1q与HCDD的血清肌酐(SCr)水平呈负相关(r=-0537,P=0048),sC5b9与HCDD的24h尿蛋白定量呈正相关(r=0688,P=0007)。尿上清C1q、Bb、C3a、C5a以及sC5b9与HCDD的24h尿蛋白定量呈正相关。尿上清C3a、C5a以及sC5b9与LCDD的24h尿蛋白定量呈正相关。
结论:HCDD组血液中存在补体旁路途径及经典途径的激活,补体活化程度与SCr及蛋白尿严重程度相关。


Abstract: Objective:To explore plasma and urine levels of complement activation produces in light chain deposition disease (LCDD) and heavy chain deposition disease (HCDD).
Methodology:A total of 42 cases in LCDD group,14 cases in HCDD group and 10 healthy controls were enrolled.We tested the classic pathway (CP) markers of C1q,alternative pathway (AP) markers of  Bb,lectin pathway (LP) markers MBL,and the coproducts of complement pathways of C3a,C5a and sC5b9 in the plasma and urine of the three groups.
Results:The C3[067 (030,100) g/L vs 082 (052,167) g/L,P<005)] and C1q levels in the HCDD group were significantly lower than those in the LCDD group[2134 (026,4400) μg/ml vs 6306 (632,56666) μg/ml,P<005].In the urine,the levels of C1q,Bb,C3a,C5a and sC5b9 in the HCDD group were significantly higher than those in the LCDD group.Plasma C1q was negatively correlated with the serum creatinine level of HCDD (r=-0537,P=0048),and sC5b9 was positively correlated with the 24hour urine protein quantification of HCDD (r=0688,P=0007).Urine C1q,Bb,C3a,C5a and sC5b9 were positively correlated with the 24hour urine protein quantification of HCDD.The urine supernatant C3a,C5a and sC5b9 were positively correlated with the 24hour urine protein quantification of LCDD.
Conclusion:HCDD patients had  activation of complement AP and CP.The degree of complement activation was related to the severity of serum creatinine and proteinuria.