抗核抗体、抗双链-DNA及核抗原抗体联合检测对系统性红斑狼疮临床诊断的价值

The Clinical Value of Combined Detection of ANA,Anti-ds-DNA and ENA in SLE

目的分析抗核抗体(ANA)、抗双链DNA(抗ds-DNA)、核抗原抗体(ENA)的联合检测,对系统性红斑狼疮(SLE)的临床诊断的意义。方法测定68例SLE患者和76例其他自身免疫病患者,以及50例健康人群血清中的自身抗体进行间接免疫荧光法测定ANA,以间接结合的放射性核素测定抗ds-DNA,以斑点法测定ENA。结果本文68例SLE患者血清自身抗体检测中,ANA、抗ds-DNA、ENA阳性率,分别为91.2%、72.1%、82.4%;特异性分别为71.4%、96.0%、79.3%。其中,ENA的检测包括6种,以抗Sm抗体为主,阳性率为42.6%,特异性为99.2%。3者联合检测阳性率为97.1%,特异性为71.4%。结论在检测的3种自身抗体中以ANA敏感性最高,其他两种抗ds-DNA与抗Sm抗体特异性可达96%以上,不过敏感性低。3者联合检测可较大程度提高SLE检测阳性率,并且单独检测特异性时,特异性有显著差异,且3者具有明显的互补作用。

Objective To analyze the clinical diagnosis value of the combined detection of anti-nuclear antibody（ANA）,anti-double-stranded DNA（anti-ds-DNA）,nuclear antigen antibodies（ENA） in systemic lupus erythematosus（SLE）.Methods 68 cases of SLE,76 cases of other autoimmune diseases and 50 healthy people were studied.To detect autoantibodies.ANA was detected by indirect immuno fluorescence（IIF） assay.ENA was detected by Dot-ELISA and anti-ds-DNA was detected by indirect detection of the radioactive nuclide.Results The serum positive rates of ANA,anti-ds-DNA,ENA were 91.2%,72.1%,82.4% and the specificities were 71.4%,96.0%,79.3% respectively in patients with SLE.ENA detection includes six kinds of testing,among them,anti-Sm is the key detection.Its positive rate was 42.6% and the specificity was 99.2%.The positive rate of combined detection of the three index was 97.1% and the specificity was 71.4%.Conclusion The sensitivity of ANA detection is the highest among three detection.The specificity of anti-ds-DNA and ant-Sm is over 96%,but them had low sensitivity.The detections of the three antibodies might have complementation in the diagnosis of SLE.