系统性红斑狼疮中医辨证分型与自身抗体谱的关系

Correlation between syndromes of traditional Chinese medicine and anti-nuclear antibody repertoire in systemic lupus erythematosus

目的探讨系统性红斑狼疮中医辨证分型与自身抗体谱检测的内在联系。方法收集确诊为系统性红斑狼疮的住院患者病历资料及相应自身抗体谱检测结果,根据四诊特点对其进行中医辨证分型。共分3型:脾肾阳虚证、热毒炽盛证及阴虚内热证,比较其自身抗体谱检测结果与中医辨证分型之间的关系。结果共收集SLE确诊病例105例,其中103例抗核抗体(ANA)阳性,3组证型间抗核抗体滴度按几何均值大小依次为热毒炽盛证>阴虚内热证>脾肾阳虚证;组间比较特异性抗核抗体谱各抗体阳性率,其中脾肾阳虚和热毒炽盛间抗组蛋白抗体阳性率差异有统计学意义(P<0.05);抗ds-DNA抗体阳性共有54例,总阳性率为51.43%,按阳性率大小依次为:脾肾阳虚证>阴虚内热证>热毒炽盛证,其中脾肾阳虚、阴虚内热组均与热毒炽盛组差异有统计学意义(P<0.05)。结论 ANA可作为系统性红斑狼疮的筛查试验,而抗组蛋白抗体及抗ds-DNA抗体可应用于系统性红斑狼疮的中医辩证分型,作为辨证的参考依据。

Objective To study the correlation between the differential syndrome patterns of traditional Chinese medicine（TCM） and anti-nuclear antibody（ANA） repertoire in patients with systemic lupus erythematous（SLE）.Methods From January,2010 to May,2011,105 inpatient cases of SLE were enrolled for detection of ANA.These patients were divided into three groups according to TCM syndrome patterns： Pi-Shen-Yang-Xu group,Re-Du-Chi-Sheng group and Yin-Xu-Nei-Re group.Results Positive ANA was detected in 103 cases,and the mean titer of ANA ranked in descending order as follows： Re-Du-Chi-Sheng group,Yin-Xu-Nei-Re group and Pi-Shen-Yang-Xu group.There was significant difference in the positive rate of anti-histone antibody（AHA） between Pi-Shen-Yang-Xu group and Re-Du-Chi-Sheng group（P0.05）.Positive anti-ds-DNA antibody was observed in 54 cases（51.43%）.A descending rank of positive rate of anti-ds-DNA antibody was observed as followed： Pi-Shen-Yang-Xu group,Yin-Xu-Nei-Re group and Re-Du-Chi-Sheng group.There were significant differences revealed between Re-Du-Chi-Sheng group and both Pi-Shen-Yang-Xu group and Yin-Xu-Nei-Re group（P0.05）.Conclusion ANA detection could be applied in screening of SLE,while AHA and anti-ds-DNA antibody detection can be applied in diagnosis of syndrome patterns of TCM.