自身抗体和补体C3、C4联合检测在SLE诊断中的意义

The significance of combined detection of autoantibody and completment C3,C4 in the diagnosis of SLE

目的探讨自身抗体和补体C3、C4联合检测在系统性红斑狼疮(SLE)诊断中的应用价值。方法收集126例SLE患者和正常对照100例健康人血清,采用间接免疫荧光法(IIF)检测抗核抗体(ANA)和抗ds-DNA抗体,免疫印迹法检测抗核抗体谱,透射免疫比浊法检测补体C3、C4。结果 SLE患者ANA阳性率为93.7%,抗ds-DNA抗体阳性率为44.4%,抗核抗体谱阳性率为90%;ANA谱中抗Sm抗体、抗nRNP抗体、抗核小体抗体、抗组蛋白抗体、抗核糖体P蛋白抗体的阳性率分别为42.9%、34.9%、30.2%、25.4%、26.9%;补体C3、C4阳性率分别为55.6%和49.2%,上述指标阳性率均明显高于健康对照组(P<0.05)。结论 ANA、抗ds-DNA抗体、抗核抗体谱及补体C3、C4联合检测可明显提高SLE的检测敏感度和特异性,对SLE患者的诊断、治疗方案的制定、疗效观察及预后评估有重要意义。

Objective To investigate the value of applications in combined detection of auto antibodies and complements（ C3,C4） to diagnose Systemic Lupus Erythematosus（ SLE）. Methods The serum of 126 patients with SLE and 100 healthy people as normal control was collected. ANA and anti- ds- DNA antibody were detected by indirect immunofluorescence（ IIF）,the spectrum of anti- nuclear antibodies was detected by immunoblotting analysis,C3 and C4 were detected by immune transmission turbidity method. Results Among the patients of SLE,the positive rate of ANA was 93. 7%; the positive rate of Anti- ds- DNAwas 44. 4%; the positive rate of the spectrum of anti- nuclear antibodies were 90%,in which the positive rates of anti- Sm antibody,Anti- nucleosome antibody,anti- histone antibody,andanti- ribosomal p antibody were separately 42. 9%,34. 9%,30. 2%,25. 4%,26. 9%. The positive C3 accounted for 55. 6%,and the positive C4 accounted for 49. 2%,which were higher than normal control obviously（ P〈0. 05）. Conclusion The combined detection of autoantibodies（ including ANA,anti- ds- DNA antibody and the spectrum of anti- nuclear antibodies） and complements（ C3 and C4）,which could increase the sensitivity and specificity of SLE apparently,could be important in diagnosis,treatment,clinical observation and prognosis evaluation for SLE patients.