不同自身抗体联合检测在系统性红斑狼疮中的诊断价值

Diagnostic value of different autoantibodies combined detection in Systemic Lupus Erythematosus

目的:对不同自身抗体联合检测在系统性红斑狼疮(SLE)中的诊断价值进行评估。方法:收集68例SLE患者组和56例其他自身免疫病(AID)组,并加以对照组50例。分别用间接免疫荧光法(IIF)和定量酶联免疫吸附法(ELISA)检测抗双链DNA(dsDNA)抗体,用IIF测定抗核抗体(ANA),线性免疫印迹法检测15种特异性IgG类自身抗体(ANA谱3)。筛查出与SLE相关性较好的指标,比较不同自身抗体联合检测模式对SLE检测的阳性率。结果:SLE组、其他AID组与正常对照组相比较不同自身抗体阳性率均有明显差异(P<0.01)。筛查出与SLE相关性好的6个指标:ANA、dsDNA、Sm、Nucleosome(核小体)、Histone(组蛋白)、ARPA(抗核糖体P蛋白抗体)。ANA、dsDNA、Nucleosome联合检测阳性率明显高于其他3种自身抗体联合检测模式(ANA、dsDNA、Sm模式,ANA、dsDNA、Histone模式和ANA、dsDNA、ARPA模式)(P<0.01)。结论:ANA、dsDNA、Sm、Nucleosome、Histone、ARPA对SLE有重要诊断价值。不同自身抗体联合检测模式可明显提高SLE诊断的检出率。ANA、dsDNA、Nucleosome联合检测对SLE有重要的诊断意义。

Objective：To evaluate the diagnostic value of different autoantibodies combined detection in the Systemic Lupus Erythematosus （SLE）. Methods： Collected 68 patients of SLE and 56 cases of other autoimmune disease （AID） and the 50 patients of the control group. The dsDNA was tested by indirect immunofluorescence （IIF） and the Quantitative enzyme linked immunosorbent assay（ELISA）, and the ANA was tested by IIF too, and the Linear Western blot detected 15 species-specific IgG class antibodies （ ANA spectrum 3 ）. Screened better indicators with SLE, and compared to the positive rate of different autoantibodies detection mode of SLE. Results ： The positive rate was significantly different in SLE group and other AID group compared with the normal control group （P〈0.01）. Screened six better indicators with SLE： ANA, dsDNA, Sm ,Nucleosome ,Histone, ARPA （anti-ribosomal P protein antibodies）. The positive rate of ANA, dsDNA, Nucleosome combined was significantly higher than the other three autoantibodies detection mode （ANA, dsDNA, Sm mode and ANA, dsDNA, Histone mode and ANA, dsDNA, ARPA mode） （P〈0. 01 ）. Conclusion： They have important diagnostic value for SLE of ANA, dsDNA, Sm, Nucleosome, Histone, ARPA. The combined detection mode of the different autoantibodies can significantly improve the detection rate of SLE. Combined detection of ANA, dsDNA, Nucleosome have the diagnostic value to SLE.