狼疮细胞对判断系统性红斑狼疮病情的临床价值研究

Clinical value of lupus cells in judgment of systemic lupus erythematosus disease

目的探讨特殊型狼疮细胞对判断系统性红斑狼疮（SLE）疾病严重性和活动性的临床价值。方法采用改良血块法对128例SLE患者特殊型狼疮细胞的观察,同时用SLE疾病活动性经典生物标记抗体：抗双链DNA（dsDNA）抗体、抗核小体抗体（AnuA）、补体及SLE活动指数（SLEDAI）作对照比较。结果狼疮细胞（LEC）存在多形态结构异常,均匀体小至笔尖大至巨核细胞出现裂隙不规则,细胞多聚集成片结构清晰可辨,有的似串葡萄、巨核细胞、双叶、多叶及降落伞等特殊形态。70例SLE患者特殊型狼疮细胞的检出与抗dsDNA抗体、AnuA和SLEDAI呈显著正相关（r=0.59,P〈0.05;r=0.76,P〈0.01;r=0.58,P〈0.05）,与C3和C4水平呈明显负相关（r=-0.65,P〈0.05;r=-0.59,P〈0.05）。结论特殊型狼疮细胞是SLE病情发展的特殊产物,经与SLE疾病活动性的经典生物标记抗体和SLEDAI比较研究,对SLE疾病的严重性和活动性判断具有更简便快速,准确可靠,经济优于生物抗体标记法的重要临床价值。

Objective To evaluate the clinical value of special lupus cells in judging the ponderance and the activity of systemic lupus erythematosus （SLE） disease. Methods The modified blood clots method was adopted to observe 128 cases of SLE patients with special lupus cells, in addition to the use of biological labeled antibody of SLE activity： anti-double strand DNA （dsDNA） antibody, anti-nucleosome antibody （AnuA）, complement and the SLE disease activity index （SLEDAI） for comparisons. Results There are abnormal cell morphology lupus of Lupus cells （ LEC）, small to the tip of a pencil or large cracks appeared irregular Megakaryocyte, cell gathered to pieces and the structure could be distinguished, some like series grapes, megkaryocyte, double - leaf, multi - leaf and parachute, etc. Detection of special lupus cell, anti-dsDNA antibodies in lupus cells, chromatin and SLEDAI of 70 SLE patients was positively correlated （ r = 0. 59, P 〈 0. 05 ; r = 0. 76 ; P 〈 0. 01 ; r = 0. 58, P 〈 0. 05 ）, but C3 and C4 level was negatively correlated （ r = - 0. 65, P 〈 0. 05 ; r = - 0. 59 ; P 〈 0. 05）. Conclusion The special lupus erythematosus cells are the production of SLE development. Compared with the classical biological labeled antibody of the activity of SLE and the SLEDAI, the lupus erythematosus cell is more convenient, accurate and economic in the estimation of seriousness and activity of SLE.