中文摘要：

目的检测B7-H4分子在狼疮性肾炎（LN）患者肾脏组织及血清中的表达。方法收集90例LN患者,急性肾外伤患者3例,20例无肾炎的SLE患者和健康体检者20例,SLEDAI评分评估LN的疾病活动性。16例LN患者接受肾活检和肾脏病理检查,免疫组织化学染色检测肾脏病理组织中B7-H4抗原表达;ELISA法检测LN患者和健康体检者血清中的可溶性B7-H4（soluble B7-H4 sB7-H4）的含量,并分析LN患者sB7-H4和临床指标的相关性。结果免疫组织化学染色显示B7-H4抗原表达于肾小管上皮细胞胞浆中,LN患者切片中5个视野下平均B7-H4阳性肾小管数百分比（45±16）%明显低于对照人群（86±11）%（P﹤0.05）,并且和肾脏组织中的肾小管间质损害积分明显负相关（r=-0.476,P=0.02）。LN患者sB7-H4含量为（58.20,中位数）ng/ml、（70.57±27.24）ng/ml、（69.12±29.31）ng/ml三者之间均差异无统计学意义,与正常对照（70.57±27.24）ng/ml和无肾炎的SLE患者无明显差异,其和SLEDAI明显正相关（r=0.353,P=0.005）。另外,LN高度活动组sB7-H4含量（74.40±31.95）ng/ml明显高于中度活动组（51.89±21.79）ng/ml（P=0.017）。结论 LN患者中B7-H4分子的表达可能参与了LN的疾病进展,但其具体机制尚需要进一步阐明。

英文摘要：

Objective To investigate the expression of B7 - H4 on renal tissue and serum in the patients with LN. Methods A total of 90 LN patients, 3 acute kidney injury patients, 20 SLE patients without nephritis and 20 healthy donors were referred. Disease activity was assessed by SLEDAI scores. The expression of B7 - H4 on kidney biopsies from patients with LN and acute kidney injury was measured using immunohistochemistry. The sB7 - H4 of serum in LN and healthy donors was analysed using ELISA, and the correlation between sB7 - H4 of serum in LN with clinical data was analysed too. Results Immunohistologieal staining revealed that B7 - H4 antigen expressed on tubular ep- ithelium, the percentage of B7 - H4 positive expression renal tubules from LN patients（45 ± 16） % was lower than that from acute kidney in- jury patients （ 86 ± 11 ） % （ P 〈 0.05 ）, and was negatively correlated with the index of tubulointerstitial damage （ r = - 0. 476, P = 0.02 ）. The sB7 - H4 in serum of LN patients （58.20 ng/ml ,median） was not significantly lower than that of healthy controls（70.57± 27.24 ng/ml）, but was strongerly associated with SLEDAI with LN （r = 0.353 ,P = 0. 006）. Besides, the mean concentration of sB7 -H4 level in high ac- tivity group （74.40 ± 31.95 ng/ml） was significantly higher than that in moderate group （51.89± 21.79 ng,/ml） （p = 0. 017 ）. Conclusion The expression of B7 - H4 molecules probably has effects during the progress of LN, and a clear understanding of its functional roles may further elucidate the pathogenesis of this disease.