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)诊断的敏感性和特异性,并探讨AnuA与其他自身抗体和SLE活动性的关系。方法选择SLE患者65例(SLE组)、疾病对照组(包括类风湿性关节炎、混合性结缔组织病、原发性干燥综合征、多发性肌炎、系统性硬化症患者)38例和正常对照组30例,采用免疫印迹法测定血清中的AnuA,同时检测并分析抗dsDNA抗体、抗Sm抗体和抗组蛋白抗体及其他实验室指标。结果AnuA、抗dsDNA抗体、抗Sm抗体的阳性率在SLE组中分别为58.5%、52.3%、30.7%,均显著高于疾病对照组(5.3%、0、7.9%)和正常对照组(0、0、0)(均P<0.05)。AnuA对SLE患者诊断的敏感性为58.5%,与抗dsDNA抗体和抗组蛋白抗体差异无统计学意义(均P>0.05),特异性为97.1%,与抗dsDNA抗体、抗Sm抗体差异无统计学意义(均P>0.05),但与抗组蛋白抗体差异有统计学意义(P<0.05)。AnuA与抗Sm抗体之间无关(P>0.05),而与抗dsDNA抗体相关(P<0.05)。AnuA与抗dsDNA抗体、抗Sm抗体联合检测诊断SLE的敏感性达83.1%。SLE组中AnuA阳性者的Hb、C3、C4水平低于AnuA阴性者(P<0.05)。结论AnuA对SLE诊断敏感性高、特异性强,是对SLE诊断有价值的实验室指标之一,并与SLE疾病活动性有关,与抗dsDNA抗体、抗Sm抗体联合检测可提高诊断敏感性。
Objective To evaluate the sensitivity and the specificity of antinucleosome antibodies （AnuA） and other autoantibodies in diagnosis of systemic lupus erythematosus （SLE）. Methods Serum AnuA was measured by immunologic blotting in 65 patients with SLE,38 cases with other rheumatic diseases including rheumatoid arthritis, mixed connective tissue diseases, primary Sjogren syndrome, polymyositis, systemic sclerosis）and 30 healthy controls. Serum anti-dsDNA, anti-Sm,anti-histone antibody and other laboratory parameters were also measured. Results Seropositive rates for AnuA, anti-dsDNA and anti-Sm in 65 SLE patients were 58.5% ,52.3% and 30.7% respectively, which were significantly higher than those in other rheumatic diseases（ 5.3% ,0% and 7.9% respectively） and healthy controls（0% ,0% and 0% ）（ P〈0.05 ）. The sensitivity of AnuA in diagnosis of SLE was 58.5%, there was no significant difference with that of anti-dsDNA and anti-Sm （P〉0.05）. and the specificity of AnuA in SLE was 97.1% ,there was no significant difference with that of anti-dsDNA and anti-Sm （P〉0.05）,while there was significant correlation between AnuA and anti-histone antibody （P〈0.05）. AnuA was correlated with anti-dsDNA （P〈0.05）, but not with anti-Sm （P〉0.05）. The sensitivity of AnuA combined with anti-dsDNA and anti-Sm for SLE was 83.1%. The levels of Hb,C3 and C4 in AnuA positive patients were lower than those in AnuA negative patients （P〈0.05）. Conclusion AnuA has high specificity and good sensitivity in diagnosis of SLE; AnuA combined with anti-dsDNA and anti-Sm might improve its diagnostic sensitivity.
出处
《浙江医学》
CAS
2008年第8期816-818,823,共4页
Zhejiang Medical Journal
