儿童系统性红斑狼疮患者自身抗体联合检测的临床意义

The clinical significance of the joint detection of autoantibodies in children with juvenile systemic lupus erythematosus

目的探讨自身抗体联合检测对于儿童系统性红斑狼疮(juvenile systemic lupus erythematosus,JSLE)的早期诊断和病情监测的意义。方法选取2012年10月至2016年7月在南京医科大学附属儿童医院住院诊治的JSLE患儿90例作为观察组,非系统性红斑狼疮风湿病患儿74例作为疾病对照组,检测抗双链DNA抗体(double-stranded DNA,dsDNA)、抗SSA、抗Sm、抗SSB等多种自身抗体水平,通过回归分析筛选出AnuA、抗dsDNA、抗Sm三种抗体,分别进行单一抗体和联合检测的敏感性和特异性分析。结果AnuA+抗dsDNA+抗Sm三种抗体联合检测的敏感性与单一抗体或dsDNA+抗Sm联合检测的敏感性差异有统计学意义(P<0.05),而特异性差异无统计学意义(P>0.05)。结论多种自身抗体联合检测可提高JSLE诊断的敏感性和效率,对JSLE的早期诊断和监测有重要意义。

Objective To explore the significance of self-antibody joint detection for early diagnosis and disease surveillance of children with systemic lupus erythematosus (SLE).Methods In October 2012to July 2016,90cases of children with juvenile systemic lupus erythematosus(JLSE)and 74cases of children with rheumatism were selected for obervation group and disease group respectively.Antibody of double-stranded DNA (dsDNA),anti SSA,anfi Sm,anti SSB were detected.AnuA,anti dsDNA and anti Sm were screened out through regression analysis.Analysis respectively for single antibody and joint detection sensitivity and specificity.Resuits There was significant difference of the sensitivity beteen joint detection of AnuA +anti dsDNA +anti Sm and single antibody,even with anti dsDNA +anti Sin,while there was no the specificity(P >0.05).Conclusion The combination multiple autoantibodies may improve the sensitivity and efficiency of the diagnosis of JSLE,and it is important for early diagnosis and monitoring of JSLE.