抗核小体抗体对系统性红斑狼疮诊断价值的探讨

Study on prevalence and diagnostic significance of anti-nucleosome antibodies in the patients with systemic lupus erythematosus

目的:探讨抗核小体抗体对系统性红斑狼疮的诊断和判断疾病活动度的价值。方法:采用酶联免疫吸附试验(EL ISA)检测45例系统性红斑狼疮、25例类风湿关节炎、16例原发性干燥综合征、8例多发性肌炎/皮肌炎、5例混合性结缔组织病、18例骨性关节炎和30例健康对照组血清中的抗核小体抗体,将抗核小体抗体与疾病活动度(以SLEDA I评分)、抗双链DNA抗体、抗Sm抗体等指标进行比较。结果:抗核小体抗体在45例系统性红斑狼疮患者34例(75.5%)阳性,其敏感度和特异度分别为75.5%,93.1%;抗核小体抗体与SLEDA I评分、抗双链DNA抗体、肾损害有相关性。结论:抗核小体抗体在系统性红斑狼疮中敏感性较高,是诊断系统性红斑狼疮和了解狼疮活动度的良好指标。

Objective To study the prevalence and diagnostic significance of antibodies against nucleosomes in the patients with systemic lupus erythematosus. Methods Anti-nucleosome antibodies were measured with ELISA in the sera of 45 cases of systemic lupus erythematosus, 25 of rheumatoid arthritis, 5 of mixed connective tissue disease, 16 of Siogren＇s syndrome, and 18 of osteoarthritis. Anti-nucleosome antibodies were compared with anti-dsDNA antibodies, anti-Smith antibodies and systemic lupus erythematosus activity. Sera of 30 healthy individuals were assayed as controls. Results The sensitivity of anti-nucleosome antibodies was 75. 5% with reasonable specifity （93. 1%） in systemic lupus erythematosus. Anti-nucleosome antibody was associated with anti-dsDNA antibody, SLEDAI and renal involvement. Conclusion The anti-nucleosome antibody presents a high sensitivity with reasonable specificity to systemic lupus erythematosus and is valuable to systemic lupus erythematosus diagnosis.