四种自身抗体联检对SLE诊断的临床价值

The Clinical Diagnostic Value of Combined Detection of 4 Autoantibodies in Patients with Systemic Lupus Erythematosus

目的:探讨抗核抗体(ANA)、抗双链DNA(ds-DNA)抗体、抗Sm抗体和抗核糖体P蛋白(r-RNP)抗体联检对系统性红斑狼疮(SLE)诊断的临床价值。方法:检测49例SLE患者、33例其他结缔组织病患者(对照组)和40名正常人血清ANA、抗ds-DNA抗体、抗Sm抗体和抗r-RNP抗体。结果:ANA、抗ds-DNA抗体、抗Sm抗体和抗r-RNP抗体在SLE患者中的阳性率明显高于对照组和正常人组(P<0.01);ANA与抗ds-DNA抗体的敏感性显著高于其他两种自身抗体(P<0.05);SLE活动期患者与非活动期患者抗ds-DNA抗体阳性率有显著性差别(P<0.01);抗ds-DNA抗体滴度与SLE-DAI呈正相关(r=0.57,P<0.01);ANA、抗ds-DNA抗体、抗Sm抗体和抗r-RNP抗体联检的敏感性可达98.0%。结论:自身抗体联检提高了SLE诊断的敏感性,对SLE的诊断和治疗有重要意义。

Objective To investigate the clinical diagnostic value of combined detection of antinucler antibody （ANA） ,anti-dsDNA antibody,anti-Sm antibody and anti-r-RNP antibody in patients with systemic lupus erythematosus （SLE） .Methods The serum levels of ANA,anti-ds-DNA antibody,anti-Sm antibody and anti-r-RNP antibody were detected in 49 SLE patients,33 patients with other connective tissue diseases and 40 controls.Results The results showed that the positive rates of ANA,anti-ds-DNA antibody,anti-Sm antibody and anti-r-RNP antibody in SLE patients were much higher than those in patients with other connective tissue diseases and controls groups （P 〈0.01） .The sensitivities of ANA and anti-ds-DNA antibody were higher than those of anti-Sm antibody and anti-r-RNP antibody in patients with SLE （P 〈0.05） .The positive rates of anti-ds-DNA antibody were significantly higher in patients with active SLE than those in patients with non-active SLE （P 〈0.01） .The anti-ds-DNA level was positively correlated with the score of SLE-DAI r = 0.57,P 〈0.01） .The positive detection rate increased to 98.0% with combined determination of ANA,anti-ds-DNA antibody,anti-Sm antibody and anti-r-RNP antibody.Conclusion The combined determination of a autoantibodies may improve the sensitivity in diagnosis greatly in patients with SLE.