Clin Exp Rheumatol:抗中性粒细胞胞浆抗体相关血管炎中的低白蛋白血症

2018-04-29 xiangting MedSci原创

肾脏受累的AAV中低白蛋白血症的发病率很高,但并非由重度蛋白尿引起。低白蛋白血症与AAV的高炎症水平和不良预后相关。

低白蛋白血症已被证明是许多疾病预后不良的生物标志物。这项研究的目的是探讨抗中性粒细胞胞浆抗体(ANCA)相关血管炎(AAV)中低白蛋白血症的意义。

研究人员回顾性分析了117例AAV患者的资料。研究了低白蛋白血症与疾病严重程度之间的关系。在体外研究了白蛋白对ANCA致病作用的影响。

在所有患者中,52例患有轻微低白蛋白血症(30g/L<=白蛋白<35g/L),40例患有肾性低白蛋白血症(白蛋白<30g/L)。与不伴低白蛋白血症的患者相比,低白蛋白血症患者的炎症水平更高、肾损伤更严重,但肾性低白蛋白血症患者和轻微低白蛋白血症患者的尿蛋白水平无显著差异。多因素分析显示血清白蛋白与年龄(r = -0.566,p = 0.018),C-反应蛋白(r = -0.521,p = 0.032)和血红蛋白(r = 0.512,p = 0.036)相关。与轻微低白蛋白血症患者或正常血清白蛋白相比,肾性低白蛋白血症患者的感染、终末期肾病发病率和全因死亡率较高。体外研究表明,白蛋白以浓度依赖性方式抑制ANCA与中性粒细胞的结合。白蛋白还抑制ANCA诱导的呼吸爆发和中性粒细胞胞外陷阱形成。

血清白蛋白对ANCA与其抗原间的结合具有抑制作用。肾脏受累的AAV中低白蛋白血症的发病率很高,但并非由重度蛋白尿引起。低白蛋白血症与AAV的高炎症水平和不良预后相关。针对低白蛋白血症的治疗有益于AAV患者。

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    2018-05-01 珙桐
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    2018-04-30 changjiu

    学习一下谢谢

    0

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    2018-04-29 1ddf0692m34(暂无匿称)

    学习了.谢谢分享

    0

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    2018-04-29 戒馋,懒,贪

    谢谢分享学习了

    0