血清和唾液抗核小体抗体在系统性红斑狼疮中的诊断意义

The diagnosis significance of serum and saliva anti-nuclearsome antibody in systemic lupus erythematosus

目的:检测血清和唾液抗核小体抗体(AnuA)对系统性红斑狼疮(SLE)诊断的敏感性和特异性,探讨二者关系及其与SLE活动性和SLE机体损伤机制的关系。方法:用双抗体夹心ELISA法定量检测72例SLE组、30例疾病对照组和24例正常组血清AnuA水平,并检测42例SLE患者和20例正常人唾液AnuA水平,记录SLE患者的各种临床表现及实验室指标,并分析它们之间的关系。结果:血清AnuA在SLE检测中的敏感性和特异性分别为56.94%和98.15%。血清AnuA和抗双链DNA抗体水平呈正相关(r=0.55,P<0.01),且与系统性红斑狼疮疾病活动性指数(SLEDAI)记分正相关(r=0.629,P<0.001)。唾液AnuA水平与血清AnuA水平正相关(r=0.380,P<0.01)。结论:血清AnuA对SLE诊断的敏感性高、特异性强,可作为判断疾病活动性的指标;唾液AnuA水平与血清AnuA水平正相关,对SLE的诊断和疾病活动性的判断有一定意义。

Objective： To investigate the diagnostic specificity and sensitivity of anti-nucleosome antibodies （AnuA） in patients with systemic lupus erythematosus （SLE） and evaluate the correlation between anti-nucleosome antibodies and disease activity in patients with SLE. To study the saliva level of AnuA in SLE patients and normal group. Methods： A sandwish ELISA was used to measure the level of AnuA in serum of 72 SLE patients, 30 patients of other rheumatic diseases and 20 healthy controls. Some saliva samples of SLE patients and healthy controls were also detected. We recorded the clinical manifest and laboratory marks of the patients, and analysed the relationship between them. Results： The sensitivity and specificity of serum AnuA in SLE were 56.94% and 98.15% respectively. The titer of serum AnuA was higher in SLE than in other rheumatic diseases group and healthy group in quantitative analysis （ P 〈 0. 01）. The levels of serum AnuA strongly correlated with the levels of serum anti-dsDNA antibodies （r = 0.55, P 〈 0.01）. The positive rate of serum AnuA in SLE with renal involved was higher than that of without （P 〈 0.05）. The titer of serum AnuA was associated with SLEDAI （r = 0.639, P 〈 0.01）. The titer of saliva AnuA was associated with serum AnuA （r = 0.380, P= 0.005）. Conclusion： Serum AnuA has high sensitivity and specificity in diagnosis of SLE. Our data suggest that the anti-nucleosome antibody showed a close relationship with disease activity, so it may be a useful marker for active assessment of SLE. Saliva AnuA level has some diagnosis significance in SLE.