抗ds-DNA定量检测在系统性红斑狼疮诊断和治疗中的应用观察

Observation of the quantitative determination of anti-double stranded DNA on diagnosis and treatment of systemic lupus erythematosus

目的探讨定量检测抗双链脱氧核糖核酸(ds-DNA)在系统性红斑狼疮(SLE)诊断和治疗中的应用价值。方法 77例SLE患者(活动期37例、缓解期40例)、74例其他结缔组织病患者和68例体检健康者血清用间接酶联免疫吸附试验定量检测抗ds-DNA,以观察比较各组差异;另对其中36例接受免疫治疗的活动期SLE住院治疗患者于治疗前和治疗后第3、7、14、20天各抽血检测抗ds-DNA、补体C3、C4、红细胞沉降率(ESR)等,以比较各指标的变化敏感性。结果活动期和缓解期SLE患者抗ds-DNA浓度与健康对照组比较差异有统计学意义(P<0.01),其他结缔组织病患者与健康对照组比较差异无统计学意义(P>0.05);36例活动期SLE患者接受免疫治疗后的第3天抗ds-DNA含量较治疗前明显下降,差异有统计学意义(P<0.05),C3和ESR治疗后第14天较治疗前有明显差别,差异有统计学意义(P<0.05),C4在治疗前后差异无统计学意义(P>0.05)。结论抗ds-DNA对SLE的诊断具有较高的敏感性和特异性,有效治疗时其下降比C3、C4和ESR等非特异性炎性指标恢复快而明显,定量检测抗ds-DNA更能显示其临床应用价值。

Objective To investigate the value of quantitative determination of anti double stranded DNA （ds- DNA） for systemic lupus erythematosus （SLE） diagnosis and therapy in clinical application. Methods Serum from 77 patients with SLE（37 patients were in active stage,40 patients were in remission stage）, 74 patients of other con- nective tissue disease and 68 healthy people were collected. Enzyme linked immune absorbent assay（ELlSA）was used to test ds DNA antibody,and we observed the different results of three groups. The levels of ds DNA, complement C3,C4,erythrocyte sedimentation rate（ESR） of 36 patients in active stage were tested before and after treatment in 3,7,14,20 days, then we compared the sensitivity of these items. Results There was a significant difference between the level of ds-DNA antibody in active, remission SLE groups and that of health controls（P^0.01）, there was no significant difference between the level of ds DNA antibody in other connective tissue group and that of the health controis （P^0.05）. The dsDNA antibody level of 36 patients in active stage decreased 3 days after treatment , the re sult showed a significant difference（P%0.05）,and there was a significant difference of the level of C3 and ESR before and 14 days after treatment （P%0.05）. But the result of C4 level before and after treatment showed no signifi cant difference（P2〉0.05）. Conclusion ds DNA antibody has high sensitive and specificity on diagnosing the SLE. And it decreases more quickly than the non specificity items of C3, C4 and ESR after the effective treatment. So quantitative determination of the ds DNA antibody has a higher value in clinical application.