抗心磷脂抗体(ACA)、抗dsDNA抗体、尿蛋白、C3、C4联合检测与系统性红斑狼疮(SLE)的临床意义

Anticardiolipin antibodie in combination with AdsDNA,urine protein,complement C3 and C4 for the clinical diagnose of systemic lupus erythematosus(SLE)

目的分析评价抗心磷脂抗体(ACA)、抗dsDNA抗体、尿蛋白、补体C3、补体C4联合检测对系统性红斑狼疮(SLE)诊断的敏感性和特异性及临床意义。方法采用酶联免疫吸附法检测140例SLE患者及40例健康查体者血清中的ACA(IgGIgAIgM),并与抗dsDNA抗体、尿蛋白I、gGI、gAI、gM、C3、C4临床指标进行相关分析。结果140例SLE患者中ACA阳性率为20.7%,抗dsDNA抗体阳性与狼疮性肾炎尿蛋白阳性组ACA的阳性率分别为32.6%、33.3%,均高于阴性组ACA的阳性率14.9%1、5.3%;按抗dsDNA抗体/尿蛋白均阴性、抗dsDNA抗体或尿蛋白任一项为阳性和抗dsDNA抗体/尿蛋白均阳性分三组:ACA阳性率为11.6%、24.1%、47.1%,χ2=11.05,P=0.004;按抗dsDNA抗体阳性和阴性、尿蛋白阳性和阴性分组:ACA的敏感性分别为32.6%、33.3%,特异性分别为85.1%、84.7%,P<0.05;用于鉴别正常人与SLE患者,ACA的敏感性为20.7%,特异性为100%。系统性红斑狼疮(SLE)活动期C3、C4降低,P<0.05。结论血清ACA抗体与系统性红斑狼疮(SLE)活动性及狼疮性肾炎有密切关系,ACA、抗dsDNA抗体、尿蛋白、C3、C4联合检测有助于对系统性红斑狼疮(SLE)活动性及狼疮性肾炎、肾损害及疾病发展的判断和疗效考核。

Objective To evaluate the sensitivity and specificity of anticardiolipin anfibodie in combination with AdsDNA,urine protein, complement C3 and C4 for the clinical diagnose of systemic lupus erythematosus （SLE）. Methods The enzyme-linked im- munosorbent assay （ELISA） was used to measure the serum ACA （IgG, IgA, IgM） in 140 SLE patients and 40 healthy controls. Theirs AdsDNA, urine protein, complement C3 .and C4 were made correlation analysis with ACA. Results The ACA positive rate is 20.7% in 140 SLE patients and is 32.6% and 33.3% in the patients with AdsDNA positive and urine protein positive patients that it is higher than AdsDNA and urine protein negative group （14.9% and 15.3%）.Three groups were set up according to AdsDNA and urine protein both negative, AdsDNA or urine protein positive and AdsDNA and urine protein both positive. The ACA positive rate is 11. 6% ,24. 1% and 47.1% respectively. X^2 = 11.05, P = 0.004） ;The sensitivity of ACA is 32.6% in AdsDNA positive patients and 33.3 % in urine protein positive patients, the specificity of ACA is 85.1% and 84.7 % respectively in the two groups patients （ P 〈 0.05） .The sensitivity of ACA is 20.7%, specliqeity is 100% that is usefal to differentiate normal control with SLE patients groups, The complement C3 and CA decreased in activity SLE patients （ P 〈 0.05）. Conclusion The ACA antibody is closely related with in SLE activity and lupus glomerulonephritis. The measure of serum ACA combine with AdsDNA, Urine protein, complement C3 and C4 can be helpful in diagnose of SLE activity and lupus glomerulonephritis and evaluation of therapeutic efficieney.