抗核小体抗体在系统性红斑狼疮及狼疮肾炎中的临床意义

The Clinical Significance of Anti-nucleosome Antibodies in Patients with Systemic Lupus Erythematosus and Lupus Nephritis

目的检测系统性红斑狼疮(SLE)患者血清抗核小体抗体(AnuA)水平,探讨AnuA与SLE及狼疮肾炎(lupus nephritis,LN)发生发展的关系,评价其对SLE病情预测的应用价值。方法采用ELISA法检测67例SLE患者(其中伴有LN 38例)、53例其他风湿病患者和27名健康对照者血清AnuA水平,进行组间比较。对34例活动期SLE患者进行随访检测,比较治疗前后AnuA水平。结果 SLE患者血清AnuA水平明显高于疾病对照组和正常对照组(P<0.01),并且LN组AnuA水平明显高于非LN组(P<0.01)。治疗后随病情转归血清AnuA水平明显降低(P<0.01)。结论 AnuA与SLE的发生发展有关,可能是SLE患者并发肾脏损害的诱发因素之一。动态检测血清AnuA水平对临床上监测SLE病情变化、指导治疗具有重要意义。

Objective To detect the level of serum anti-nucleosome antibodies （ AnuA ） in systemic lupus erythematosus （ SLE ） , to investigate the relationship between AnuA and SLE and lupus nephritis （ LN ）, so as to assess the utility of AnuA for markers of disease activity in SLE. Methods AnuA were detected by enzyme-linked immunosorbent assays （ ELISA ） in the sera of 67 SLE patients （ including 38 LN patients ）, 53 patients with other rheumatic diseases and 27 healthy person. Results The serum level of AnuA in SLE patients was significantly higher than that of the control group （ P 〈 0.01 ）, and in SLE patients with LN it was also higher than those of without LN （ P 〈 0.01 ）. The level of AnuA in 34 SLE patients after treatment was significantly lower than that of pre-treatment（ P 〈 0.01 ）. Conclusions AnuA may play a role in the pathogenesis of SLE and the high level of serum AnuA is correlated with renal lesion. The dynamic observation of the level of serum AnuA may help to predict the prognosis and treatment effectiveness of the disease.