抗dsDNA抗体检测在系统性红斑狼疮中的价值探讨

Value of detection of anti-dsDNA antibody in diagnosis of systemic lupus erythematosus

目的探讨抗dsDNA抗体检测在系统性红斑狼疮(SLE)中的应用价值。方法选取187例SLE患者为研究对象,采用间接免疫荧光法检测ANA和抗dsDNA抗体,欧蒙斑点法检测ENA抗体谱。将82例抗dsDNA抗体阳性的患者设为观察组,对照组为105例抗dsDNA抗体阴性的患者,比较两组患者SLE疾病活动指数、狼疮肾炎发病情况及临床表现的差异;对两组患者进行免疫学指标的检测,比较两组的差异。结果观察组患者SLE疾病活动指数评分高于对照组(P<0.05),狼疮肾炎的发病率高于对照组(P<0.05),抗dsDNA抗体与患者的发热和关节炎的发生有关(P<0.05);抗dsDNA抗体阳性可伴有Anu A、抗U1RNP抗体阳性率增高,IgG含量增高,C3含量降低(P<0.05)。结论 SLE患者抗ds-DNA抗体阳性者的临床表现和免疫学指标变化具有不同的特点,可能其参与了SLE疾病的活动和狼疮肾炎的发生,故抗dsDNA抗体检测在SLE的诊断中具有一定的价值。

Objective To explore the value of detection of anti- dsDNA antibodiy in diagnosis of systemic lupuserythematosus（SLE）. Methods A total of 187 cases with SLE were enrolled in this study, ANA and anti-dsDNA antibody incases were detected with indirect immunity fluorescence test and ENA antibody were detected with EUROASSAY. The 82 anti-dsDNA antibody-positive patients were selected as observation group, and the 105 anti-dsDNA antibody-negative patientswere selected as control group.SLE disease activity index, lupus nephritis and clinical manifestations in patients of both groupswere compared. Immunological indexes of patients in the two groups were also measured for comparison. Results Patients inobservation group had a higher SLE disease activity index（ P〈0.05）and higher incidence of lupus nephritis（P〈0.05）thanpatients in control group. The anti-dsDNA antibody was correlated with the occurrence of fever and arthritis（P〈0.05）; Theanti-dsDNA could lead to Anu A, increase the positive rate of anti-U1 RNP antibody and content of IgG,and cut down C3 level（P〈0.05）. Conclusion The clinical manifestation and changes of immunological index in SLE patients positive for anti-dsDNA antibody were multiple and anti- dsDNA antibody might involved in the activities of SLE and occurrence of lupusnephritis, thus detection of anti-dsDNA antibody is of significance in the diagnosis of SLE.