摘要
目的探索抗核小体抗体(ANuA)在系统性红斑狼疮(SLE)患者发病和诊断中的临床意义。方法采用免疫斑点法,对101例SLE患者、260例其他风湿免疫性疾病患者(包括类风湿关节炎96例,骨关节炎61例,强直性脊柱炎30例等)血清ANuA进行了检测,同时检测抗核抗体(ANA)、抗双链DNA(ds-DNA)抗体、抗可提取核抗原(ENA)抗体等,并结合临床表现及实验室指标进行分析。结果 SLE患者血清ANuA检测的敏感性40.6%(41/101),特异性99.2%(2/260);活动组SLE患者ANuA阳性率(58.1%)明显高于稳定组(26.3%);ANuA阳性的SLE患者红细胞沉降率、ANA滴度、抗ds-DNA量、疾病活动度SLEDAI评分、狼疮肾炎和雷诺现象发生率等明显高于ANuA阴性患者(P<0.05),而补体C3、C4则低于ANuA阴性患者(P<0.01);ANuA检测与抗ds-DNA抗体、抗组蛋白抗体的检测具有一致性,而与其他自身抗体如抗Sm、SSA、心磷脂抗体等无关。结论 AnuA对SLE的诊断的一定敏感性和高度的特异性,它与SLE疾病活动性和狼疮肾炎的发生等相关。
Objective To explore the role of anti-nucleosome antibodies（ANuA） in the pathogenesis and diagnosis of patients with systemic lupus erythematosus（SLE）.Methods Serum ANuA was measured with immuno-spot assay in 101 SLE patients and 260 patients with other rheumatic diseases including 96 rheumatoid arthritis patients,61 osteoarthritis patients and 30 ankylosing spondylitis patients.At the same time,anti-nuclear antibodies（ANA）,anti-ds-DNA antibodies,anti-ENA antibodies were examined and the clinical manifestations were recorded.Clinical significance of ANuA was then analyzed accordingly.Results The sensitivity and specificity of ANuA in SLE were 40.6% and 99.2% respectively.The incidence of ANuA in active SLE patients was higher（58.1%） than in non-active SLE patients（26.3%）.ESR,ANA titer,anti-ds-DNA,SLE Disease Activity Index（SLEDAI） score,incidence of lupus nephritis and Raynaud phenomenon were higher in ANuA positive SLE than in ANuA negative SLE（P0.05）;however,levels of C3 and C4 were on the contrary.ANuA was related to anti-ds-DNA and anti-histone antibodies,but not related to other auto-antibodies such as anti-Sm and anti-SSA.Conclusion ANuA is to some extent sensitive and very specific to the diagnosis of SLE and it is useful to evaluate lupus activity and lupus nephritis.
出处
《临床和实验医学杂志》
2011年第2期96-98,共3页
Journal of Clinical and Experimental Medicine
关键词
系统性红斑狼疮
抗核小体抗体
免疫斑点法
Systemic lupus erythematosus
Anti-nucleosome antibodies
Immuno-spot
