四种方法检测抗dsDNA抗体的对比分析

Comparison of the Four Anti-dsDNA Antbody Detecting Tests

目的比较化学发光法（CLIA）、酶联免疫吸附法（ELISA）、间接免疫荧光法（IIFA）和免疫印迹法（IB）检测抗dsDNA抗体的差异，为临床寻找合适的检测方法。方法收集2010年6月～2011年5月住院病人血标本共86例，包括系统性红斑狼疮（SLE）42例、类风湿关节炎（RA）18例和其他自身免疫性疾病26例；另设健康对照34例。同时用以上四种方法检测样本中的抗dsDNA抗体，比较每种方法的敏感度和特异度，同时通过受试者工作曲线（ROC）比较四种方法的诊断性能。结果四种方法检测抗dsDNA抗体，在SLE患者组，ELISA敏感度最高（83．33％），其次CLIA（80．95％），IIFA（73．81％），IB敏感度最低（30．95％）；前三种方法对检测抗dsDNA抗体的敏感度之间差异无统计学显著性意义（P〉0．05），但与IB相比，差异均有统计学显著性意义（P〈0．05）；特异度方面，IB特异度最高（100．00％），其次为ILFA（97．44％），CLIA（91．03％），ELISA的特异度最低（88．46％），其中，CLIA与ELISA和IB，ELISA与IIFA比较，差异有统计学显著性意义（P〈0．05）。ROC曲线下面积分别为0．915，0．925，0．997和0．667，其中，CLIA，ELISA，IIFA与IB，CLIA与IIFA比较，差异有统计学显著性意义（P〈0．05）。结论ELISA和IIFA联合检测抗dsDNA抗体，能互相补充，提高对抗dsDNA抗体的检出率，有助于SLE的诊断及病情监测。

Objective To compare the four test [chemiluminescenceimmunoassay（CLIA）,enzyme-linkedimmunosorbentassay （ELISA） ,indirectimmunofluorescence assay（IIFA） and immunoblot（IB）] for detecting anti-dsDNA antbody with 86 serum sample to look for a suitable method. Methods 120 serum samples including 42 serum samples of SLE, 18 serum samples of rheumatoid arthritis,26 serum samples of other autoimmune disease and 34 serum samples of healthy were measured by CLIA,ELISA,IIFA and IB. All parameters were compared such as sensitivity,specificity. At the same time all the methods were evaluated by ROC. Results Detected the anti-dsDNA antbody of the serum sample with the methods of CLIA,ELISA, IIFA and lB. For SLE, the sensitive of the four methods was 80. 95 %, 83.33 %,73.81% and 30.95 % respectively, signifi- cant diference was found between CLIA and IB, ELISA and IB, IIFA and IB. Specificity was 91.03 %, 86.67 %, 97.44 % and 100.00% respectively, significant diference was found between CLIA and IB, ELISA or IB, ELISA and IIFA. The ROC area was 0. 915,0. 925,0. 997 and 0. 667. Significant diference was found between CLIA and IB, ELISA and IB, IIFA and IB, CLIA and IIFA. Conclusion The combination of ELISA and IIFA for detection the anti-dsDNA antbody can complement each other and enhance positive rate,which will be helpful for the diagnosis and monitoring of curative effect for SLE.