Coombs实验阳性SLE患者的血清自身抗体结果分析

Analysis of autoantibodies detection results in SLE patients with positive Coombs test

目的了解Coombs实验阳性和阴性系统性红斑狼疮(SLE)患者之间ANA、ACA、ENA、抗dsDNA抗体检测结果差异,分析Coombs实验分型与自身抗体表达的关系。方法收集86例Coombs实验阳性SLE患者血清,采用间接免疫荧光法检测ANA,滴金免疫渗滤法检测ACA、ENA和抗dsDNA抗体,以81例Coombs实验阴性SLE患者作为对照组。结果 Coombs实验阳性SLE患者组抗dsDNA抗体和抗SSB抗体阳性率显著高于Coombs实验阴性SLE患者组(χ2=5.208,P<0.05;χ2=5.012,P<0.05)。Coombs实验各分型组比较,IgG+C3d型组和C3d型组之间3种抗体阳性率存在显著性差异,分别是抗Sm抗体(χ2=6.737,P<0.01)、抗u1RNP抗体(χ2=7.851,P<0.01)和抗SSA抗体(χ2=10.393,P<0.01)。C3d型组与IgG型组之间2种抗体阳性率存在显著性差异,分别是抗u1RNP抗体(χ2=10.776,P<0.01)和抗SSA抗体(χ2=4.010,P<0.05)。结论 Coombs实验阳性和阴性SLE患者间及Coombs实验各分型组间自身抗体表达存在差异。

Objective To understand the differences of laboratory detection results of antinuclear antibody （ANA）, anti - cardi- olipin antibody（ ACA）, antibodies to extractable nuclear antigen （ENA） and anti -double stranded DNA （dsDNA） antibodies between SLE patients with positive Coombs test results and those with negative results, and to investigate the relationship be- tween Coombs test antibody types and autoantibodies. Methods Eighty - six SLE patients with positive Coombs test results and eighty- one SLE patients with negative Coombs test results were enrolled in this study, and the latter acted as control group. ANA was detected by indirect immunofluorescence assay, and ACA, anti - ENA and anti - dsDNA antibodies were measured through dot immunogold filtration assay. Results The positive rates of anti - dsDNA and anti - SSB antibodies in SLE patients with positive Coombs test results were significantly higher than patients with negative Coombs test results （χ2 = 5. 208, P 〈 X2 0.05 ; = 5. 012, P 〈 0. 05 ）. The positive rates of anti - Sin, anti - ul RNP and anti - SSA autoantibodies were significantly different between IgG ＋ C3d group and C3d group （χ2 = 6. 737, P 〈 0.01 ; χ2 = 7. 851, P 〈0. 01; χ2 = 10. 393, P 〈 0.01 ）. Moreover, the positive rates of anti -ulRNP and anti -SSA autoantibodies were significantly different between C3d group and IgG group （χ2 = 10.776, P 〈 0. 01 ; χ2 = 4. 010, P 〈0. 05 ）. Conclusion Expression of autoantibodies had statistical differ- ence between SLE patients with positive Coombs test results and those with negative Coombs test results, as well as among differ- ent Coombs test antibody type subgroups.