5种自身抗体联合检测对系统性红斑狼疮的诊断价值  

Application of combined detection of five auto-antibodies in diagnosis of SLE

作　　者：邹伟华[1] 顾金华[1] 王笑颜[1] 吴泉[1] 

机构地区：[1]湖州市中心医院,浙江湖州313000

出　　处：《浙江医学教育》2009年第1期51-53,共3页Zhejiang Medical Education

摘　　要：目的:研究抗核抗体(ANA)、抗双链DNA(dsDNA)抗体、抗Sm抗体、抗核小体抗体(AnuA)和抗核糖体P蛋白抗体(ARPA)对诊断系统性红斑狼疮(SLE)及提高敏感性的临床价值。方法:测定132例SLE患者及10.5例疾病对照组(原发性干燥综合征、系统性硬化症、类风湿关节炎、混合性结缔组织病、多发肌炎等)患者血清中的自身抗体。利用间接免疫荧光法测定ANA和免疫印迹法测定抗dsDNA抗体、抗Sm抗体、AnuA和ARPA。结果:ANA对SLE的敏感性高而特异性较低,敏感性与其它自身抗体相比,差异有统计学意义(P<0.01)。抗dsDNA抗体、抗Sm抗体、AnuA和ARPA对SLE的特异性高而敏感性较低,联合检测可明显提高敏感性,差异有统计学意义(P<0.01)。结论:ANA可作为SLE的筛查试验,dsDNA抗体、抗Sm抗体、AnuA和ARPA联合检测能明显提高SLE诊断敏感性并保持较高的诊断特异性。[Objective]To compare the specificity and sensitivity of antinuclear antibodies(ANA) and antibodies against double stranded DNA(ds- DNA),Smith(Sm),Nucleosome(AnuA),Ribosome P protein(ARPA) in diagnosis of systemic erythematosus (SLE),and evaluate the clinical significance of combined detection of these autoantibodies in diagnosis of SLE. [Method]One hundred and thirty - two SLE patients and one hundred and five patients with other auto - immune diseases were studied.The latter included primary Sjogren syndrome,systemic sclerosis,rheumatoid arthritis,mixed connective tissue disease, ploymyositis.Indirect immunofluorescence was used to detect the ANA,and the western blotting was used to detect the other antibodies.[Result]The sensitivity of ANA in SLE patients was higher than that of other antibodies(P< 0.01),the specificity of ANA was reverse.The specificities of the ds - DNA,Sm,AnuA,ARPA antibodies in SLE patients were higher man that of ANA antibodies(P< 0.01).[Conclusion]ANA could be used as a screening market of diagnosis of the SLE.Autoantibodies against ds - DNA,Sm,AnuA,ARPA had higher specific in diagnosis of SLE,These four antibodies had complementary contribution to the diagnosis of SLE,and combined detection of them could significantly improve the sensitivity of the diagnosis of the SLE.

关 键 词：系统性红斑狼疮 自身抗体 联合检测 敏感性 特异性 

分 类 号：R593.241[医药卫生—内科学]