抗核抗体系列及补体检测对狼疮性肾炎的诊断意义

The diagnostic significance of detecting antinuclear antibody series and complement for patients with lu-pus nephritis

目的探讨抗核抗体系列及补体检测对系统性红斑狼疮（SLE）伴狼疮性肾炎（LN）诊断的意义。方法对1699例SLE患者和120例健康体检者采用间接免疫荧光法测定抗核抗体（ANA），应用欧蒙印迹法测定抗核抗体系列，应用散射比浊法测定补体C3、C4。结果1699例SLE患者，LN组921例，ANA阳性率为97．4％；不伴LN组778例，ANA阳性率为98．2％；与对照组比较，r=0．983，P=0．001，差异有统计学意义。LN组的抗组蛋白抗体，抗核小体抗体，抗双链DNA抗体阳性率分别为49．3％、59．8％、63．3％；不伴LN组分别为21．5％、35％、47．9％；差异有统计学意义（r=0．452，P=0．007）。抗线粒体-2抗体和抗着丝点抗体阳性率，LN组与不伴肾炎组比较差异有统计学意义（r=0．291，P=0．015）。当抗组蛋白抗体＋抗核小体抗体＋抗双链DNA抗体同时阳性时，LN患者其补体C3，C4水平比这三种抗体非同时阳性时的水平均更低，差异有统计学意义（r=0．583，P=0．009）。结论抗核抗体系列及补体的血清学检测对诊断LN及其预后判断、疗效观察等具有重要意义。

Objective To explore the diagnostic significance of detecting antinuclear antibody （ANA） series and complement for patients with lupus nephritis （LN） of systemic lupus erythematosus （SLE）. Methods ANA was detected by indirect immunity fluorescent method. ANA series were detected by EUROIMMUN blot- ting. Complements （C3 and CA） of 1699 SLE patients and 120 healthy controls were detected by nephelometry. Results Among 1699 SLE patients, the positive rate of ANA was 97.4% in 921 patients with LN,while the pos- itive rate of ANA was 98.2% in 778 patients without nephritis. There was significant difference between patients and controls （ r = 0. 983 ,P = 0. 001 ）. In patients with LN, the positive rate of anti-historic, -nucleosome and - ds- DNA antibodies （3-pos） was 49.3% ,59.8% ,and 63.3% ,respectively. The positive rate of the corresponding an- tibodies in patients with on nephritis was 21.5% ,35% ,and 47.9% ,respectively. The difference between patients with and without nephritis was significant （ r = 0. 452, P = 0. 007 ）. The positive rate of anti-mitochondria-2 and anti-centromere was statistically difference between the two groups of patients （r = 0. 291 ,P = 0. 015 ）. The C3 and CA levels of 3-pos LN patients were significantly lower than that of non 3-pos patients （ r = 0. 583, P = 0. 009 ）. Conclusion Combined detection of ANA series and complement C3 and C4 is important for the clinical diagnosis of SLE with LN, and it may provide information for evaluating the prognosis of SLE patients.