抗核小体抗体对系统性红斑狼疮的诊断意义

Diagnostic significance of anti-nucleosome antibodies in systemic lupus erythematosus

关键词:  抗核小体抗体  红斑狼疮  系统性

Key words:  anti-nucleosome antibodies  lupus erythematosus  systemic

摘要:

［目的］探讨抗核小体抗体（AnuA）的检测对系统性红斑狼疮（SLE）的诊断价值及其与SLE活动性的关系。［方法］选择SLE患者60例、疾病对照组30例和正常对照组30例，采用ELISA方法测定血清AnuA，同时检测并分析抗ds-DNA抗体、抗Sm抗体两项实验室指标。［结果］AnuA、抗ds-DNA抗体和抗Sm抗体在SLE患者中阳性率分别为75.00%、50.00%、35.00%，均明显高于疾病对照组（10.00%、6.67%、3.33%）及正常对照组（0、0、0），P均<0.05。AnuA对SLE诊断的敏感性为75.00%，与抗ds-DNA抗体（50.00%）和抗Sm抗体（35.00%）比较差异有显著性意义（P<0.05），特异性为90.00%，与抗ds-DNA抗体和抗Sm抗体比较差异无显著性意义（P>0.05）。活动期AnuA阳性率明显高于非活动期，AnuA在活动期的阳性率（91.7%）高于抗ds-DNA的阳性率（66.7%），AnuA、抗ds-DNA抗体和抗Sm抗体联合测定的敏感性为91.67%。［结论］AnuA的检测在SLE患者中表现为出现时间早，特异性强，敏感性高，可以作为临床早期诊断SLE的重要指标之一，且与SLE疾病活动性有关。与抗ds-DNA抗体、抗Sm抗体联合检测有助于提高诊断敏感性。

Abstract:

［Objective］To explore the diagnostic value of anti-nucleosome antibodies (AnuA) and the relationship with activity of systemic lupus erythematosus (SLE).［Methods］AnuA in the serum of 60 SLE patients, 30 disease control group and 30 normal control group were tested by enzyme linked immunosorbent assay (ELISA) method, at the same time anti-ds-DNA antibody and anti-Sm antibody were detected and analyzed. ［Results］The positive rate of AnuA, anti-ds-DNA antibody and anti-Sm antibody in SLE were 75.00%, 50.00% and 35.00%. They were higher than disease control (P<0.05) and normal control (P<0.05) groups. The sensitivity of AnuA was 75.00% in SLE and it was difference with anti-ds-DNA antibody and anti-Sm antibody (P<0.05). The specificity of AnuA was 90.00%, but it had no difference with them (P>0.05). In addition AnuA in active stage was significantly higher than that in non-active stage. The positive rate of AnuA in active stage was higher than anti-ds-DNA antibody. The sensitivity of combination of AnuA and anti-ds-DNA antibody and anti-Sm antibody was 91.67%. ［Conclusion］AnuA in SLE can contribute to earlier diagnosis. It has high sensitivity and specificity and can act as marker of clinical diagnosis of early stage in SLE. Combination of AnuA, anti-ds-DNA antibody and anti-Sm antibody can increase the clinical diagnosis sensitivity.