抗核抗体谱中阳性的自身抗体数目对狼疮诊断的意义

Significance of positive autoantibodies number in antinuclear antibody spectrum for diagbosing systemic lupus erythematosus

目的探讨抗核抗体谱(ANAs)中阳性的自身抗体数目对系统性红斑狼疮(SLE)诊断的意义。方法共1 297例患者纳入分析,其中SLE患者148例,非SLE风湿病患者317例,肾脏疾病患者99例,血液病患者210例,其他组患者523例。免疫印迹法检测各组患者ANAs,率的比较采用χ~2检验,ROC曲线分析阳性的自身抗体数目在SLE诊断中的价值。结果阳性的自身抗体数目对SLE具有很好的诊断价值,曲线下面积为0.934;SLE组中自身抗体的阳性率为93.92%,高于其他各组(P<0.01),自身抗体阳性数目大于或等于3时,阳性似然比大于10(72.78),对SLE诊断具有很好的预测价值。结论免疫印迹法检测的ANAs中3种及3种以上自身抗体阳性高度提示SLE。

Objective To evaluate the significance of positive autoantibodies number in antinuclear antibodies（ANAs） spectrum for the diagnosis of systemic lupus erythematosus（SLE）. Methods A total of 1 297 patients were included in this study,a- mong them 148 cases were SLE,317 cases were non-SLE rheumatic diseases, 99 cases were nephropathy,210 cases were hematological diseases,and 523 cases were other diseases as the control group. The ANAs level in each group was detected by immunoblotting. The rate comparison adopted the chi square test. The value of positive autoantibodies number in diagnosing SLE was analyzed by receiver operating characteristie（ROC） curve. Results The positive autoantibodies number had good diagnostic value for SLE. The area under the curve was 0. 934;the positive rate of autoantibodies（AAbs） in the SLE group was 93.92 %, which was much higher than that in other groups（P〈0.01）. When the number of positive-AAbs was ≥3, the positive likelihood ratio was greater than 10（72.78） ,showing a very good predictive value for the diagnosis of SLE. Conclusion Three or more kinds of positive-AAbs is highly suggestive of SLE.