抗核抗体及其变化在系统性红斑狼疮的临床意义

The Clinical Significance of Antinuclear Antibody(ANA) and Its Changes in Systemic Lupus Erythematosus(SLE)

探讨抗核抗体及其变化在系统性红斑狼疮（ＳＬＥ）的临床意义。对５０例ＳＬＥ病人血清进行连续五年的追踪观察。结果：ＩＦＡＮＡ、抗ｄｓ－ＤＮＡ、抗Ｓｍ、抗Ｕ１－ＲＮＰ、抗ＳＳ－Ａ、抗ＳＳ－Ｂ抗体的阳性率分别为１００％、７０％、３０％、４４％、５２％、２２％。ＩＦＡＮＡ的滴度高低与病情活动状况无关，转阴并不表示病情缓解；抗ｄｓ－ＤＮＡ抗体与狼疮性肾炎相关，持续高滴度常表示疾病活动特别是狼疮肾活动；抗Ｓｍ抗体与病情无关，治疗后易消失；抗Ｕ１－ＲＮＰ抗体与雷诺氏现象相关；抗ＳＳ－Ａ抗体与光敏感相关；抗ＳＳ－Ｂ抗体与干燥综合征相关；这三种抗体多持续存在。表明在ＳＬＥ，各种ＡＮＡ可能代表不同的亚型。

To study the clinical significance of ANA and it’s change in SLE,Fifty patients with SLE were investigated consecutively for five years.Results:IFANA was positive in 100% of patients,antids DNA in 70%,antiSm in 30%,antiU1RNR in 44%,antiSSA in 52%,and antiSSB in 22%.IFANA titers did not correlate with the activity of disease and its change from positive to negative did not predict remission AntidsDNA was associatied with lupus nephritis and its sustained hightiter indicated activity of disease,especially of renal disease.AntiSm did not correlate with disease activity and might disappear after treatment.AntiU1RNP was correlated with Raynaud’s phenomenon,antiSSA with photosensitivity,and antiSSB with Sjogren’s syndrome.Usually the latter three antibodies did not disappear.Conclusions:In patients with SLE,various ANAs may represent different subtypes.