| Objective:Compare the levels of plasma soluble EPCR (sEPCR) and soluble TM (sTM) in patients with systemic lupus erythematosus , lupus nephritis and in normal control group, to explore the significance of sEPCR and sTM in patients with systemic lupus erythematosus and lupus nephritis.Methods:From 2010-2 to 2011-6, 32 cases of patients with systemic lupus erythematosus and 38 cases of patients with lupus nephritis who were hospitalized in the First Affiliated Hospital of Soochow University and the First People's Hospitial of Kunshan were enrolled in this study. 38 case of lupus nephritis were performed renal biopsy and divided groups according to the result of renal biopsy: 9 cases with lupus nephritis classⅡ, 6 cases with lupus nephritis classⅢ, 20 cases with lupus nephritis classⅣand 3 cases with lupus nephritis calssⅤ. According to the SLEDAI score, 70 case of patients with systemic lupus erythematosus and lupus nephritis were divided two groups: 33 cases of pantiengs less than 9 points were divided to one group, the others were divided to the other group.20 cases of healthy controls were also enrolled. Plasma sEPCR and sTM were measured by the enzyme-linked immunosorbent assay (ELISA); Hemagglutination and D-dimer were detected routine. And the clinical and laboratory data of the patient were collected.Result:1.The levels of D-dimer in patients with systemic lupus erythematosus and lupus nephritis were significantly higher than that of in controls (P<0.05), the levels of fibrin in patients with lupus nephritis were significantly higher than that of in controls (P<0.05). 2. The levels of plasma sEPCR and in patients with systemic lupus erythematosus and lupus nephritis were significantly higher than that of in controls (P<0.05,P<0.01), The levels of plasma sTM in patients with systemic lupus erythematosus and lupus nephritis were significantly higher than that of in controls (P<0.05) ; The levels of plasma sEPCR in patients with lupus nephritis were significantly higher than that of in patients with systemic lupus erythematosus (P<0.05), The levels of plasma sTM in patients with lupus nephritis were significantly higher than that of in patients with systemic lupus erythematosus (P<0.01).3. The levels of plasma sEPCR and sTM in the patients whose SLEDAI score were more than or equal to 9 points were singnificantly higher than that of in patients whose SLEDAI score were less than 9 points (P<0.01).4. The levels of plasma sEPCR and sTM in the patients with lupus nephritis classⅣwere singnificantly higher than that of in patiengs with lupus nephritis classⅡ(P<0.01), The levels of plasma sEPCR in the patients with lupus nephritis classⅣwere singnificantly higher than that of in patiengs with lupus nephritis classⅢ(P<0.01), The levels of plasma sTM in the patients with lupus nephritis classⅣwere singnificantly higher than that of in patiengs with lupus nephritis classⅢ(P<0.05), The levels of plasma sTM in the patients with lupus nephritis classⅡwere singnificantly lower than that of in patiengs with lupus nephritis classⅢ(P<0.05).5. In SLE and LN patients, the levels of plasma sEPCR had a positive correlation with plasma D-dimer (r=0.432,P<0.05), a positive correlation with SLEDAI (r=0.567,P<0.01), a positive correlation with ESR (r=0.314,P<0.05).6.The levels of plasma sTM had a positive correlation with plasma D-dimer (r=0.538,P<0.05), a positive correlation with SLEDAI (r=0.498,P<0.05), a positive correlation with ESR (r=0.393,P<0.05).7. The levels of plasma sEPCR had a positive correlation with the levels of plasma sTM(r=0.419 P<0.05).Conclusion:1. The plasma sEPCR has positive correlation with sTM, sEPCR may be used as a new indicator of endothelial dysfunction.2. The levels of plasma sEPCR and sTM in the patients with systemic lupus erythematosus and lupus nephritis were significantly higher than that of in controls. The levels of plasma sEPCR and sTM in the patients with systemic lupus erythematosus and lupus nephritis had a positive correlation with plasma D-dimer, SLEDAI and ESR. The sEPCR and sTM may be involved in the pathophysiological process in the systemic lupus erythematosus and lupus nephritis. The sEPCR and sTM may serve as predictors of lupus activity.3. The levels of plasma sEPCR and sTM in the patients with lupus nephritis classⅣwere singnificantly higher than that of in patiengs with lupus nephritis classⅡ,ⅡandⅤ. In the patients with LN, the levels of plasma sEPCR and sTM may be the predictors of the severity of the disease. |
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