抗核抗体与补体检测在系统性红斑狼疮诊断中的意义

Significance of Anti-nucleosome Antibody and Complement in Diagnosis of Systemic Lupus Erythematosus

目的探讨抗核抗体(ANA)和补体C3、C4检测在系统性红斑狼疮(SLE)诊断中的意义。方法对我院52例SLE患者和40例健康体检者用间接免疫荧光法检测ANA,用散射比浊法检测C3、C4。结果52例SLE患者的ANA阳性率为92.3%,与对照组比较,差异有统计学意义(P<0.05)。补体C3、C4值(x-±s)分别为(0.74±0.34)、(0.18±0.09),比对照组低,差异有统计学意义(P<0.05)。3个指标间相关关系为:C3与C4呈正相关关系,C4与ANA呈负相关关系,且相关有统计学意义(P<0.05);而C3与ANA未呈现相关关系。判别分析得到的分类方程式为病例组:Y1=-43.858+7.316×性别+0.425×年龄+14.701×C3+57.190×C4+10.125×ANA;对照组:Y2=-36.500+9.520×性别+0.397×年龄+19.694×C3+44.672×C4+4.893×ANA;利用上述分类函数方程式,对病例和对照进行判断,判断SLE患者的符合率为88.5%,判断正常对照的符合率为100%。结论检测ANA、C3、C4对SLE有较高的诊断价值,其中C4的意义最大,在诊断SLE的实验室检测中是必不可少的3个指标。

Objective To explore the role of anti - nuclesome antibodies （ANA） and complement components C3 ,C4 in the diagnosis of systemic lupus erythematosus. Methods ANA was detected by indirect immunity fluorescent method and C3, C4 were detected by nephelometry in the serum of 52 SLE and 40 health controls. Results Out of 52 SLE ,92. 3% were positive for ANA, there were significantly statistical differences between the case group and the control group （ P 〈 0. 05 ）. The levels of complement C3, C4 were （ 0. 74 ± 0. 34 ）, （ 0. 18 ± 0. 09 ） respectively, which were lower than those of control group , and there were statistical differences between the two groups （ P 〈 0. 05 ）. There was the positive bivariate correlation between the serum levels of C3 and C4, negative bivariate correlation between the levels of C4 and ANA in the SLE patients （ P 〈 0. 05 ）. And there was not correlation between C3 and ANA. Two equations were given by discrimination analysis, that were： case group Y1 = -43. 858 ＋ 7. 316 × sex ＋0. 425 × age ＋ 14. 701 ×C3 ＋57. 190 × C4 ＋ 10. 125× ANA; control group Y2 = - 36. 500 ＋ 9. 520 × sex ＋ 0. 397 ×age＋ 19. 694 × C3 ＋ 44. 672 × C4 ＋ 4. 893 × ANA; to distinguish the two groups by the two equations, the coincidence percentage was 88.5% in case group and 100% in control group. Conclusion ANA ,C3 and C4 were very valuable in the diagnosis of SLE, especially C4. they were indispensable markers in the diagnosis of SLE.