儿童系统性红斑狼疮血清抗C1q抗体的检测及意义

Detection and significance of anti-C1q antibody in the diagnosis of children with systematic lupus erythematosus

目的探讨抗C1q抗体与儿童系统性红斑狼疮(systemic lupus erythematosus,SLE)的相关性及临床意义,为儿童SLE的早期诊断提供经验。方法选择包头医学院第一附属医院2009年6月至2013年12月间初诊住院SLE患儿40例,同期健康儿童20例。记录患儿和健康儿童抗C1q抗体、抗ds DNA抗体、抗SM抗体、抗U1RNP抗体、抗SSA抗体、抗SSB抗体、补体C3、C4等相关免疫检验指标并分析其与抗C1q抗体的相关性。结果 1)SLE患儿与健康儿童平均年龄相比,差异无统计学意义(P>0.05);2)40例SLE儿童抗C1q抗体阳性率为37.5%,而健康儿童组抗C1q抗体均为阴性,两组阳性率比较差异有统计学意义(χ2=8.1,P<0.01),抗C1q抗体对儿童SLE的诊断敏感度为37.5%,特异度为100%;抗ds DNA抗体对儿童SLE诊断的敏感度为62.5%,特异度为95%;抗SM抗体对儿童SLE诊断的敏感度为22.5%,特异度为90%。3)抗C1q抗体阳性组的抗SM抗体、抗RNP抗体、抗SSA抗体、抗SSB抗体、补体C3、C4与抗C1q抗体阴性组比较,差异无统计学意义(P>0.05);两组抗ds DNA抗体相比,差异有统计学意义(χ2=5.98,P=0.02);4)抗ds DNA抗体与抗C1q抗体正相关(r=0.51,P<0.01)。结论抗C1q抗体对儿童SLE的诊断具有较高的特异性,有助于抗ds DNA抗体阴性的儿童SLE的诊断。

Objective The aim of this study was to determine the associations of anti-C1q antibody with patients of children with systemic lupas erythematosus（SLE） and its potential clinica1 significance,and to explore its early clinical diagnostic significance for children with systemic lupas erythematosus. Methods There are 40 cases of SLE and 20 healthy volunteers in children were derived from the First Affiliated Hospital of Baotou Medical College from Jun. 2009 to Dec. 2013, the laboratory data of 40 cases of SLE were retrospectively analyzed,such as anti-SSA, anti-SSB, anti-RNP, anti-dsDNA, anti-SM, C3, C4. A method of enzyme-linked immunosorbent assay was used to detect the serum anti-C1q antibodies in 40 cases of SLE and 20 healthy volunteers, and the correlation between the anti-C1q antibodies and the laboratory data was analyzed. Results 1） The mean age was similar in children with systematic lupus erythematosus and controls（P〉0. 05）. 2） Among 40 SLE children, the anti-C1q antibodies of 15 SLE children were positive, while the anti-C1q antibodies of 20 healthy controls were negative. Significant difference between the two groups（x^2 =8. 1, P〈0. 01）. The sensitivity of anti-C1q antibodies in SLE children was 37. 5% and the specificity was 100% . The sensitivity for anti-dsDNA antibodies was 62. 5% and the specificity was 95% . The sensitivity for anti-SM antibodies was 22. 5% and the specificity was 90% . 3） Comparing anti-C1q-positive and -negative patients, there was no difference in concentrations of anti-SSA, anti-SSB, anti-RNP, anti-Sm, C3, C4. However, there are significant differences between the two groups of anti-dsDNA antibodies（x^2 =5. 98, P=0. 02）. 4） A positive correlation was found between anti-dsDNA levels and both anti-C1q（r=0. 51, P〈0. 01）. Conclusion Our study demonstrated ClqAb has a higher sensitivity in diagnosis of SLE in children, which is helpful to the diagnosis of SLE in children with negative anti-dsDNA antibodies.