抗核小体抗体与系统性红斑狼疮疾病活动及狼疮肾的关系

The relationship between antinuclear antibody and systemic lupus erythematosus complicated with lupus nephritis

目的探讨抗核小体抗体(AnuA)与狼疮活动及狼疮肾炎的关系。方法用酶联免疫吸附方法(ELISA)检测75例系统性红斑狼疮(SLE)组患者、50例其它风湿性疾病(NSLE)组患者以及30例健康对照组血清AnuA水平,同时检测患者血清抗dsDNA抗体、抗-Sm抗体、抗rRNP抗体。分析AnuA对SLE组的诊断价值以及与疾病活动及狼疮肾的关系。结果AnuA在SLE患者的敏感性和特异性分别为69.3%和98%,敏感性高于抗dsDNA抗体、抗-Sm抗体、抗rRNP抗体,而特异性与它们没有区别;AnuA在狼疮肾炎(LN)患者中的阳性率为85.4%,在非LN患者中的阳性率为40.7%,二者差异极显著(P<0.01),疾病活动组AnuA阳性率显著高于疾病稳定组(P<0.05),AnuA阳性组患者口腔溃疡及肾炎的发生率显著高于AnuA阴性组(P<0.05)。结论AnuA是SLE的又一标志性抗体,AnuA与抗dsDNA抗体、抗-Sm抗体、抗rRNP抗体联合检测,可提高SLE的诊断率。AnuA的检测有助于SLE患者疾病活动及LN的判断。

Objective To investigate the relationship between antinuclear antibody（AnuA） and systemic lupus erythematosus （SLE） complicated with lupus nephritis （LN）. Methods The enzyme-linked immunosobent assay （ELISA） was used to measure AnuA in serum of 75 patients with SLE （SLE group） and 50 patients with other rheumatic diseases（NSLE group）, and 30 healthy subjects were used as control group, meanwhile anti-dsDNA antiboday, anti-Sm antibody, anti-rRNP antibody were detected in three groups. The significances of AnuA in SLE and the relationship between AnuA and Systemic lupus rethematosus complicated with lupus nephritis were analyzed. Results The sensitivity and specificity of AnuA in SLE were 69.3% and 98% respectively, the sensitivity of AnuA was higher than anti-dsDNA antiboday, anti-Sm antibody, anti-rRNP antibody, and there wao no obvious difference in specificity between AnuA and the other three antibodies. The positive rate of AnuA in patients with lupus nephritis was 85.4%, which was 40.7% in patients without LN , there was a significantly difference in the positive rate of AnuA between patients with LN and patients without LN（ P 〈 0. 01）. the positive rate of AnuA in patients at diaease activity stage was significantly higher than that in patients at disease stable stage（ P 〈 0.05）.The positive rates of oral cavity ulcer and LN were higher in patients with positive AnuA than that in patients with negative AnuA. Conclusion AnuA may be a well marked antibody for SLE. Combined detection of AnuA, anti-dsDNA antiboday, anti-Sm antibody and anti-rRNP antibody could improve the diagnosis of SLE. AnuA is correlate with diseases activity and LN. Detection of AnuA may contribute to judging diseases activity and LN.