The Clinical Significance Of Plasma STM And SEPCR In Patients With Lupus Nephritis

Objective:To explore the clinical significance of plasma soluble thrombomodulin (sTM) and soluble endothelial cell protein C receptor (sEPCR) in patients with lupus nephritis(LN).Methods:54 patients with LN and 18 healthy volunteers were enrolled in this study,there was no significant difference between the two groups in gender,age and body mass index (BMI) respectively.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of plasma sTM and sEPCR, and the relationship with vascular endothelial injury,systemic lupus erythematosus activity (SLEDAI), renal function, proteinuria,types of renal pathology.Results:1.sTM:The level of plasma sTM in LN group was significantly higher than that of the control group(P<0.01).Further analyzed,the level of sTM in typeâ…£was significantly higher than that of typeâ…¢,typeâ…¤and the control group(P<0.01);the level of sTM in typeâ…¢and typeâ…¤were higher than that of the control group(P<0.05).2.sEPCR:The level of plasma sEPCR in LN group was significantly higher than that of the control group(P <0.01).Further analyzed,the level of sEPCR in typeâ…£was higher than that of typeâ…¢,typeâ…¤(P<0.05),and significantly higher than that of the control group(P<0.01); the level of sEPCR in typeâ…¢and typeâ…¤were higher than that of the control group(P<0.05).3.CRP:The level of CRP in LN group was significantly higher than that of the control group(P<0.01).Further analyzed,the level of CRP in typeâ…£was significantly higher than that of typeâ…¢,typeâ…¤and the control group(P<0.01);the level of CRP in typeâ…¢and typeâ…¤were higher than that of the control group(P<0.05).4.Correlation analysis:Plasma sTM was positively correlated with sEPCR in LN group(P<0.05),sTM and sEPCR were positively correlated with CRP(P<0.05).sTM was positively correlated with SLEDAI(P<0.05),sEPCR was significantly positively correlated with SLEDAI (P<0.01),CRP was positively correlated with SLEDAI(P<0.05).sTM was positively correlated with Scr and 24h urinary protein levels(P<0.05),sEPCR was positively correlated with 24h urine protein levels(P < 0.05).Plasma sTM,sEPCR and SLEDAI were not correlated with blood pressure(systolic and diastolic blood pressure),blood lipid,blood albumin,BUN,ESR,Immunoglo- bulin,complement levels,or autoantibodies(P>0.05).Conclusion:1.The higher level of Plasma sTM and sEPCR in LN group suggest the presence of vascular endothelial cell injury in LN, microvascular and macrovascular endothelial injury are often in combination with each other;2.The levels of plasma sTM and sEPCR not only related to the activity of lupus but also with the type of pathology;3.Plasma sTM and sEPCR may be involved in micro-inflammation of LN, and they may play an important role in endothelial injury,the occurrence of inflammatory lesions and disease progression.