系统性红斑狼疮患者血清抗亲环素A抗体检测的临床意义

Clinical Significance of Serum Anticyclophilin A Auto-Antibodies in Patients with Sys-tem Lupus Erythematosus

目的:观察血清抗亲环素(CyP)A抗体对系统性红斑狼疮(SLE)的诊断价值与临床意义。方法:用ELISA方法检测54例SLE、36例其他自身免疫病患者及40例健康对照者血清IgG、3种抗CyP A抗体并结合活动性评分、系统损害进行分析。结果:54例SLE患者中23例检出IgG型抗CyP A抗体,15例IgM型、3例IgA型抗CyP A抗体。IgG型抗CyP A抗体的灵敏度为42.6％,特异性为55.6％,IgM型CyP抗体的灵敏度为27.8％,特异性为36.1％。SLE重度活动组两型抗CyP A抗体检出率高于稳定期及轻、中度活动组。IgG型及IgM型抗体与血中低补体及免疫球蛋白升高有关,IgG型抗CyP A抗体与SLE关节肌肉症状及白细胞减少有关。结论:IgG型抗CyP A抗体检出的临床价值优于IgM型抗体。CyP A抗体非SLE特异性抗体,但可作为判断SLE病情活动性的参考指标之一。

Objective:To investigate the Clinical significance of serum anticyclophilin A (CyP A) autoantibodies in patients with system lupus erythematosus(SLE). Methods: Serum anticyclophilin A IgG, IgM and IgA autoantibodies were detected by the method of ELISA in 54 SLE patients,36 patients with other autoimmune diseases and 40 health controls.At the same time, the correlation between serum anticyclophilin A autoantibodies and SLE disease activity index score and system injures in SLE was examined. Results: Serum anticyclophilin A IgG, IgM and IgA-autoantibodies were detected respectively in 23, 15 and 3 cases of the 54 patients with SLE. The sensitivity of method detecting IgG and IgM-Antibodies were 42.6% and 27.8% and the specificity were 55.6% and 36.1% respectively.The positive rate of-anticyclophilin A IgG and IgM antibodies was higher in patients with high activity than that of patients with low or no activity.The anticyclophilin A IgG and IgM antibodies was negatively correlated to the complement and positively correlated to the immunoglobulin. The anticyclophilin A IgG antibodies was associated with the symptom of myalgia and arthralgia as well as leukopenia. Conclusions: Clinical significance of serum anticyclophilin A IgG autoantibodies is more important than IgM.Serum anticyclophilin A autoantibodies may not be specific in diagnosing SLE but can serve as an index of activity in SLE.