抗核小体抗体在系统性红斑狼疮中的临床应用

The Clinical Application of Anti-nucleosome Antibody in Systemic Lupus Erythematosus

目的探讨抗核小体抗体(AnuA)在系统性红斑狼疮(SLE)中的临床应用价值。方法选择SLE患者60例,其中狼疮性肾炎(LN)36例,SLE非肾炎者24例。采用免疫印迹法检测SLE患者组的血清AnuA,同时进行抗-dsDNA抗体、抗-Sm抗体的检测。结果AnuA对SLE诊断的特异性为98.6%,敏感性为55.0%,显著高于抗-Sm抗体(P<0.01),但与抗-dsDNA抗体的差异无显著性(P>0.05);SLE患者组AnuA与抗-Sm抗体之间无相关性(P>0.05),但与抗-dsDNA抗体显著相关(P<0.01),联合检测AnuA、抗-dsDNA抗体、抗-Sm抗体诊断SLE的敏感性达76.7%;LN组的AnuA和抗-dsDNA抗体的阳性率分别为75.0%和63.9%,均显著高于SLE非肾炎组(P<0.01)。结论AnuA对SLE具有高度特异性和较高敏感性,是SLE的另一标志性抗体,联合检测AnuA、抗-dsDNA抗体、抗-Sm抗体能有效提高SLE的实验诊断率;血清AnuA的检测有助于LN的诊断。

Objective To explore the clinical application of anti-nueleosome antibody（AnuA） in systemic lupus erythematosus（SLE）. Methods Immunologic blotting was used to detect serum AnuA in 60 patients with SLE ,of which 36 cases had lupus nephritis（LN） and 24 cases had no LN. Meanwhile, anti-dsDNA and anti-Sin were detected. Results The specificity of AnuA in SLE was 98.6%. The sensitivity of AnuA in SLE was 55.0% ,which was significantly higher than that of anti-Sm（P〈0. 01） while had no significant difference with that of anti-dsDNA（P〉0. 05）. There was no correlation between AnuA and anti-Sm in SLE group（P〉0. 05）,while there was significant correlation between AnuA and anti-dsDNA in SLE group（P〈0. 01）. The positive rate of combining AnuA and anti-dsDNA as well as anti-Sm for SLE was 76.7%. The positive rates of AnuA and anti-dsDNA in LN group were 75.0% and 63.9% respectively,both of which were significantly higher than those in SLE without LN group （P〈0. 01）. Conclusions AnuA has high specificity and good sensitivity in SLE and might be a well marked antibody for SLE. Combining AnuA and anti-dsDNA as well as anti-Sin might improve the sensitivity of diagnosing SLE greatly. Detecting AnuA might contribute to diagnosing LN greatly.