抗核抗体与抗核抗体谱检测对系统性红斑狼疮的诊断价值

Diagnostic Value of Antinuclear Antibody and Antinuclear Antibody Spectrum Detection in Systemic Lupus Erythematosus

目的探讨抗核抗体(ANA)与ANA谱(ANAs)检测对系统性红斑狼疮(SLE)的诊断价值。方法选择2019年5月至2022年6月于医院就诊的SLE患者45例纳入SLE组,另择同期39例其他自身免疫性疾病(AID)患者纳入对照组。两组均行ANA与ANAs检测,比较两组检测阳性率,分析不同抗体对SLE的诊断价值。结果SLE组ANA、抗SS-A抗体、抗nRNP/Sm抗体、抗双链DNA抗体、抗核糖体P蛋白抗体、抗核小体抗体、抗RO-52抗体、抗组蛋白抗体阳性率均高于对照组,差异有统计学意义(P<0.05);两组抗Sm抗体、抗SS-B抗体、抗着丝粒蛋白B抗体、抗Jo-1抗体、抗SCL-70抗体阳性率比较,差异无统计学意义(P>0.05)。ANA的诊断灵敏度>90%,抗Sm抗体、抗nRNP/Sm抗体、抗双链DNA抗体、抗核糖体P蛋白抗体、抗核小体抗体、抗SS-B抗体、抗着丝粒蛋白B抗体、抗Jo-1抗体、抗SCL-70抗体、抗组蛋白抗体的诊断特异度均>90.00%,ANA、抗SS-A抗体、抗nRNP/Sm抗体、抗双链DNA抗体、抗核小体抗体、抗RO-52抗体的诊断准确度均>60.00%。结论ANA诊断SLE的灵敏度较高而特异度不足,ANAs诊断SLE的灵敏度较低而特异度较高,临床可根据需要将两者联合应用于SLE的诊断中,以提高诊断效能。

Objective The diagnostic value of antinuclear antibody(ANA)and ANA spectrum(ANAs)detection in systemic lupus erythematosus(SLE)was explored.Methods With selection of 45 SLE patients admitted to the hospital from May 2019 to June 2022 included in the SLE group,and 39 other autoimmune disease(AID)patients during the same period in the control group,the positive rates of the two groups were compared to analyze the diagnostic value of different antibodies for SLE,with the detection of ANA and ANAs in both groups.Results The positive rates of ANA,anti-SS-A,anti-nRNP/Sm,anti-dsDNA,anti-rRNP,ANuA,anti RO-52,and AHA in SLE group were higher than those in the control group,with statistically significant differences(P<0.05);There were no statistically significant differences in the positive rates of anti-Sm,anti-SS-B,anti-CENP-B,anti-Jo-1 antibody and anti-SCL-70 antibody between the two groups(P>0.05).The diagnostic sensitivity of ANA was greater than 90%;The diagnostic specificity of anti-Sm,anti-nRNP/Sm,anti-dsDNA,anti-rRNP,ANuA,anti-SS-B,anti-CENP-B,anti-Jo-1,anti-SCL-70,and AHA were all more than 90.00%;The diagnostic accuracy of ANA,anti-SS-A,anti-nRNP/Sm,anti-dsDNA,ANuA and anti-RO-52 were all more than 60.00%.Conclusion With high sensitivity and low specificity in diagnosing SLE for ANA,and low sensitivity and high specificity for ANAs,the combination of the two can be applied in the diagnosis of SLE according to needs to improve the diagnostic efficacy in clinical practice.