RESUMO
Objective To investigate the clinic-pathological significance of von Willebrand factor (vWF) and P-selectin expression in patients with lupus nephritis (LN).Methods Biopsy specimens from 71patients with LN whose disease course ranged from 2 months to 10 years were examined and scored according to a standardized method.SLE activity was evaluated by the SLE disease activity index (SLEDAI) and the British Isles Lupus Assessment Group index.Immunohistochemistry was used to detect the expressions of vWF and P-selectin in the renal tissue of LN patients and 10 normal controls.Of all the patients,7 had World Health Organization type Ⅱ,10 had type Ⅲ and 36 had WHO type Ⅳ,18 had type Ⅴ lupus nephritis.At the same time,the 24-h urine protein (UP) excretion level,the serum creatinine,the serum C3,C4,album level,antinuclear antibody (ANA),anti-double stranded DNA and disease activity scores of all patients were detected.The relationship of their expressions with the clinicopathological parameters of lupus nephritis was analyzed.ANOVA,Nemenyi test and Pearson's analysis were used for statistical analysis.Results Compared with the control group,the in situ expressions of vWF and P-selectin in the lupus nephritis patients were significantly higher.Among these patients,renal expressions of vWF were higher in type Ⅳ (0.30±0.10) than those with type Ⅱ and Ⅲ (0.12±0.05,0.22±0.14)(x2=9.273,x2=8.712,P＜0.05),while the expressions of P-selectin were higher in type Ⅳ and Ⅴ (0.29±0.05,0.36.±0.10)than those in type Ⅱ and Ⅲ (0.27±0.09,0.29±0.05 )(P＜0.05).Correlation analysis indicated that vWF was correlated significantly with AI and 24-h UP (r=0.403,0.332,P＜0.05 ),while P-selectin was correlated significantly with the scores of activity index (AI),24-h UP excretion rate and SLEDAI (r=0.283,0.453,0.297,P＜0.05 ).The expression of vWF was also closely related to P-selectin expressions (r=0.371,P=0.001).Conclusion These results indicate that vWF and P-selectin play a critical role in the pathogenesis of LN.The detection of these two factors will provide a valuable clinical reference for renal damage.These information provide valuable clues for making better treatment regimen plan and achieving more favorable prognosis.