免疫相关指标及核抗原抗体在系统性红斑狼疮患者中的诊断价值

Diagnostic Value of Immune-related Indicators and Nuclear Antigen Antibodies in Patients with Systemic Lupus Erythematosus

【目的】探讨免疫相关指标及核抗原(ENA)抗体在系统性红斑狼疮(SLE)患者中的诊断价值。【方法】SLE患者80例,根据患者病情分为活动期组(35例)和非活动期组(45例)。选取健康志愿者40例作为对照组。检测比较三组对象外周血免疫相关指标(IgA、IgM、IgG、C3、C4)以及ENA抗体(抗ds-DNA、抗Sm、抗SSA、抗SSB、抗u1RNP)水平的差异。使用ROC曲线分析相关指标对活动期SLE的诊断价值。【结果】三组间IgA、IgM、C3、C4、IgG、抗ds-DNA、抗Sm、抗SSA、抗SSB、抗u1RNP差异均具有统计学意义(P<0.05)。活动期组患者IgA、IgM、IgG分别高于对照组、非活动期组,C3、C4分别低于对照组、非活动期组,且差异有显著性(P<0.05);非活动期组IgA、IgG高于对照组,C3低于对照组(P<0.05)。活动期组、非活动期组患者抗ds-DNA、抗Sm、抗SSA、抗SSB、抗u1RNP阳性率高于对照组,且差异有显著性(P<0.05);非活动期组、活动期组间各ENA抗体阳性率相比较差异无显著性(P>0.05)。IgA诊断活动期SLE的最佳临界点为4.5g/L。当IgA为4.5g/L时,IgA诊断活动期SLE的灵敏度为71.5%,特异度为80.1%;AUC曲线下面积为0.81。【结论】免疫相关指标及ENA抗体在SLE患者中诊断价值较高,且IgA、IgG及C3能较好提示病情进展情况。

【Objective】To investigate the diagnostic value of immune-related indicators and nuclear antigen(ENA)antibodies in patients with systemic lupus erythematosus(SLE).【Methods】A total of 80 patients with SLE were selected and divided into the active group(35 cases)and the inactive group(45 cases)according to the disease activity condition.Forty healthy volunteers were selected as the control group.Peripheral blood immune related indicators(IgA,IgM,IgG,C3,C4)and ENA antibodies(anti-ds-DNA,anti-Sm,anti-SSA,anti-SSB,anti-nRNP)were examined and compared among the tree groups.The ROC curve was used to analyze the diagnostic value of relevant indicators for active SLE.【Results】There were significant differences in IgA,IgM,C3,C4,IgG,anti-ds-DNA,anti-Sm,anti-SSA,anti-SSB and anti-nRNP among the three groups(P<0.05).The levels of IgA,IgM and IgG in the active group were higher than those in the control group and the inactive group;while levels of C3 and C4 were lower than those in the control group and the inactive group(P<0.05).The IgA and IgG levels in the inactive group were higher than those in the control group,and C3 level in the inactive group was lower than that in the control group(P<0.05).The positive rates of anti-ds-DNA,anti-Sm,anti-SSA,anti-SSB and anti-nRNP in the active and inactive groups were higher than those in the control group(P<0.05).There was no significant difference in the positive rate of each individual ENA antibody between the inactive group and the active group(P>0.05).The optimal critical point for IgA diagnosis of SLE 4.5g/L.When IgA was 4.5 g/L,the sensitivity of IgA in the diagnosis of SLE was 71.5%,the specificity was 80.1%,and the area under the AUC curve was 0.81.【Conclusion】Immunologically relevant indicators and ENA antibodies have higher diagnostic value in patients with SLE,and IgA,IgG and C3 can better indicate the progress.