抗细胞膜DNA抗体、抗核抗体、抗心磷脂抗体诊断系统性红斑狼疮的临床价值及与病情发展的关系

Clinical value of anti-cell membrane DNA antibody,anti-nuclear antibody and anti-cardiolipin antibody in the diagnosis of systemic lupus erythematosus and its relationship with disease development

目的探讨抗细胞膜DNA抗体(cmDNA)、抗核抗体(ANA)、抗心磷脂抗体(ACA)诊断系统性红斑狼疮(SLE)的临床价值及与病情发展的关系。方法选取2020年3月至2020年12月收治的50例SLE患者作为观察组,同期选取50例其他自身免疫性疾病患者和50例健康体检者,分别作为疾病对照组和健康对照组。比较三组研究对象的cmDNA、ANA及ACA阳性表达情况;分析cmDNA、ANA及ACA单独诊断与联合诊断对SLE患者的诊断效能;比较SLE活动期与非活动期患者的cmDNA、ANA及ACA阳性表达情况。比较cmDNA、ANA及ACA阳性与阴性患者肾脏损害、关节炎及血管炎发生情况。结果观察组的cmDNA、ANA及ACA阳性率均高于疾病对照组和健康对照组,且疾病对照组高于健康对照组(P<0.05)。cmDNA、ANA及ACA联合检测的灵敏度、阴性预测值均高于cmDNA、ACA检测,特异度、阳性预测值均高于ANA、ACA检测(P<0.05)。SLE活动期患者的cmDNA、ANA及ACA阳性率均高于SLE非活动期患者(P<0.05)。cmDNA、ANA及ACA阳性患者的关节炎、血管炎发生率与阴性患者比较,差异无统计学意义(P>0.05);cmDNA、ANA及ACA阳性患者的肾脏损害发生率均高于阴性患者(P<0.05)。结论cmDNA、ANA及ACA能够有效诊断SLE,也能反映病情发展情况,可作为诊治SLE的参考指标。

Objective To explore the clinical value of anti-cell membrane DNA antibody(cmDNA),anti-nuclear antibody(ANA)and anti-cardiolipin antibody(ACA)in the diagnosis of systemic lupus erythematosus(SLE)and its relationship with disease development.Methods A total of 50 patients with SLE treated from March 2020 to December 2020 were selected as observation group,and 50 patients with other autoimmune diseases and 50 healthy people were selected as disease control group and healthy control group respectively.The positive expressions of cmDNA,ANA and ACA in the three groups were compared,the diagnostic efficacy of cmDNA,ANA and ACA alone and combined diagnosis in SLE patients were analyzed;the positive expressions of cmDNA,ANA and ACA in active and inactive SLE patients were compared.The incidence of renal damage,arthritis and vasculitis in cmDNA,ANA and ACA positive and negative patients were compared.Results The positive rates of cmDNA,ANA and ACA in the observation group were higher than those in the disease control group and the healthy control group,and those in the disease control group were higher than the healthy control group(P<0.05).The sensitivity and negative predictive value of combined detection of cmDNA,ANA and ACA were higher than those of cmDNA and ACA detection,and the specificity and positive predictive value were higher than those of ANA and ACA detection(P<0.05).The positive rates of cmDNA,ANA and ACA in patients with active SLE were higher than those in patients with inactive SLE(P<0.05).There were no significant differences in the incidence of arthritis and vasculitis between cmDNA,ANA and ACA positive patients and negative patients(P>0.05);the incidence of renal damage in cmDNA,ANA and ACA positive patients was higher than that in negative patients(P<0.05).Conclusion cmDNA,ANA and ACA can effectively diagnose SLE and reflect the development of the disease,which can be used as reference indexes for the diagnosis and treatment of SLE.