自身抗体检测在系统性红斑狼疮合并难治性血小板减少患者病情评估中的价值

Value of autoantibody detection for illness assessment in systemic lupus erythematosus patients with refractory thrombocytopenia

目的:分析自身抗体检测在系统性红斑狼疮(SLE)合并难治性血小板减少患者病情评估中的价值。方法:60例SLE合并难治性血小板减少患者作为观察组A,58例单纯SLE患者为观察组B,66例接受体检的健康人作为对照组。抽取研究对象的外周循环血并检测自身抗体、病情相关因子及Th17、Th1、Th2细胞因子和补体等水平,进一步分析SLE伴难治性血小板减少患者特征性抗体阳性率与病情严重程度的相关关系。结果:观察组A抗RNP抗体、抗Sm抗体、抗Scl-70抗体、抗AnuA抗体、抗His抗体、抗双链DNA(ds-DNA)抗体阳性率均高于观察组B及对照组(P<0.05);观察组A可溶性细胞间黏附分子-1(sICAM-1)、血浆血栓调节蛋白(PTM)、可溶性CD30配体(sCD30L)、单核细胞趋化蛋白1(MCP-1)值高于观察组B及对照组(P<0.05);观察组A血清白介素(IL)-17、IL-23、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、IL-4、IL-5、IL-6值均高于观察组B及对照组(P<0.05);观察组A血清C1qAg、C3、C4、补体因子(CFH)值低于观察组B及对照组,C1qAb值高于观察组B及对照组(P<0.05);SLE患者的抗Sm抗体及抗ds-DNA抗体阳性率与血清sICAM-1、PTM、sCD30L、MCP-1、IL-17、IL-23、IFN-γ、TNF-α、IL-4、IL-5、IL-6、C1qAb值呈正比,与C1qAg、C3、C4、CFH值呈反比(P<0.05)。结论:系统性红斑狼疮合并难治性血小板减少患者的自身特异性抗体阳性率高,且与患者病情严重程度存在直接相关关系,可作为远期临床治疗指导、预后判断的可靠指标。

Objective：To analyze the value of autoantibody detection for illness assessment in systemic lupus erythematosus patients with refractory thrombocytopenia.Methods：A total of 60 cases of systemic lupus erythematosus（SLE）patients with refractory thrombocytopenia were the observation group A,58 cases of patients with SLE alone were the observation group B,and 66 cases of healthy people who received physical examination were control group.Peripheral circulating blood was drawn from research subjects to detect the levels of autoantibody,illness-related factors,Th17,Th1 and Th2cytokines,complements,and so on,and then the correlation between specific antibody positive rate and disease severity in SLE patients with refractory thrombocytopenia was further analyzed.Results：Anti-RNP antibody,anti-Sm antibody,anti-Scl-70 antibody,anti-AnuA antibody,anti-His antibody and anti-ds-DNA antibody positive rates of observation group A were significantly higher than those of observation group B and control group（P〈0.05）;soluble intercellular cell adhesion molecule（sICAM-1）,plasma thrombomodulin（PTM）,sCD30 Land motocyte chemoattractant protein-1（MCP-1）values of observation group A were significantly higher than those of observation group B and control group（P〈0.05）;serum interleukin（IL）-17,IL-23,IFN-γ,tumor necrosis factor-α（TNF-α）,IL-4,IL-5and IL-6values of observation group A were significantly higher than those of observation group B and control group（P〈0.05）;serum C1 qAg,C3,C4 and complement factor H（CFH）values of observation group A were lower than those of observation group B and control group while C1 qAb value was significantly higher than that of observation group B and control group（P〈0.05）;anti-Sm antibody and anti-ds-DNA antibody positive rates of SLE patients were positively correlated with serum sICAM-1,PTM,sCD30 L,MCP-1,IL-17,IL-23,interferon-γ（IFN-γ）,TNF-α,IL-4,IL-5,IL-6and C1 qAb values,and negatively correlated with C1 qAg,C3,C4 and CFH values（P〈0.05）.Conclusions：Specific autoantibody positive rates are high in systemic lupus erythematosus patients with refractory thrombocytopenia,have direct correlation with the disease severity and can be used as the reliable indexes of long-term clinical treatment guidance and prognosis judgment.