抗DNA酶B检测用于强直性脊柱炎诊断临床价值研究

The clinical value of anti-DNA enzyme B determination in patients with ankylosing spondylitis

目的研究强直性脊柱炎患者血清中抗DNA酶B测定的临床价值。方法采用胶乳凝集法和酶联免疫吸附法(ELISA)测定2009年4—9月山东大学附属省立医院风湿免疫科门诊和病房收治的65例强直性脊柱炎(AS)患者和96名正常人血清中抗溶血性链球菌溶血素O(ASO)和抗DNA酶B抗体滴度,并按抗DNA酶B滴度阳性和阴性分成两组进行临床分析。结果 AS组ASO阳性率为47.7%,显著高于对照组(20.8%,P<0.05);AS组DNA酶B抗体阳性率58.5%,显著高于对照组(25.0%,P<0.05)。DNA酶B抗体和ASO两种抗体的检测在AS患者中差异无统计学意义(P>0.05)。抗DNA酶B阳性组的AS患者平均年龄明显低于阴性组(P<0.05)。AS患者抗DNA酶B阳性组膝关节、踝关节肿痛、臀部疼痛、"4"字征阳性、WBC升高、C反应蛋白升高的发生率明显高于阴性组(P<0.05)。结论 AS患者溶血性链球菌感染发生率高于正常人,链球菌感染与AS病情活动有一定的关系。

Objective To study the clinical value of anti-DNA enzyme B determination in patients with ankylosing spondylitis（AS）.Methods Anti-streptolysin O（ASO） and anti-DNA enzyme B in serum of 65 patients with AS who visited Shandong Provincial Hospital between April and September of 2009 and of 96 healthy controls were examined by latex agglutination and enzyme-linked immunosorbent assay（ELISA）.The patients were divided into two groups according to anti-DNA enzyme B being positive or not for clinical analysis.Results Positive rates of ASO（47.7%） and DNA-B antibody（58.5%） in AS group were significantly higher than those in the control group（20.8%;25.0%;P〈0.05）.There was no significant difference in DNA-B antibody and ASO antibody among the AS patients（P〈0.05）.In the AS group,patients who tested positive for anti-DNA enzyme B were significantly younger than those with negative results（P〈0.05）,and those who tested positive for anti-DNA-B experienced higher incidences of swelling and pain over knee and ankle,hip pain,positive sign of ＂figure 4＂,increased WBC and C reactive protein than those who did not（P〈0.05）.Conclusion Hemolytic streptococcus infection appeared more frequent in AS patients than in healthy individuals,suggesting that streptococcal infection may be related with AS activity.