抗核小体抗体与儿童系统型红斑狼疮的相关性  

Correlation of anti-nucleosome antibodies with juvenile systemic lupus erythematosus

作　　者：赵青[1] 吴凤岐[1] 张伟[1] 

机构地区：[1]中国医学科学院中国协和医科大学基础医学研究所免疫学系,北京100005

出　　处：《基础医学与临床》2005年第8期712-716,共5页Basic and Clinical Medicine

基　　金：国家自然科学基金(30170878)

摘　　要：目的探讨抗核小体抗体(AnuA)在诊断儿童系统型红斑狼疮(SLE)中的敏感性和特异性,了解AnuA与儿童SLE临床特征、疾病活动性的相关性。方法用Hep-2细胞提取核小体。用酶联免疫吸附方法(ELISA)测定血清中的AnuA,分析AnuA和临床表现的相关性。结果52例SLE中18例AnuA阳性。27例疾病对照组中1例AnuA阳性,30例正常对照组AnuA均为阴性。AnuA在儿童SLE中的敏感性为35%,特异性为96%。AnuA阳性组SLE患儿100%有中枢神经系统损害,AnuA阴性组为47%(χ2=14.57,P<0.05)。AnuA阳性组SLE患儿100%有肾脏损害,AnuA阴性组为51%(χ2=13.31,P<0.05)。AnuA阳性和AnuA阴性的SLE患儿SLEDAI评分高于10分者分别为100%和71%(χ2=6.56,P<0.05)。结论AnuA对儿童SLE的诊断具有较高的特异性,有助于抗dsDNA抗体、抗心磷脂抗体阴性的儿童SLE的诊断。Objective To evaluate diagnostic value of antinucleosome antibodies （AnuA） in juvenile systemic lupus erythematosus（SLE） and to analyze the relationship of AnuA with clinical manifestation, activity of SLE. Methods Enzyme-linked immunosorbent assay （ELISA） was used to measure AnuA in serum of 52 children with SLE. Control sera were collected from 30 healthy donors and 27 children with other rheumatic diseases including Juvenile rheumatoid arthritis, Juvenile ankylosing spondylitis, Dermatomyositis and Beheet＇s disease. Results AnuA was positive in 18 SLE patients and 1 in other rheumatic diseases, all healthy donors were negative. The sensitivity and specificity of AnuA in SLE were 35% and 96%, respectively. The incidences of renal disorders was 100% in SLE with positive AnuA and was 51% in SLE with negative AnuA （x^2 = 13.31, P 〈 0.05）. The incidence of central nervous system （CNS） involvement was 100% in SLE with positive AnuA and was 47% in SLE with negative AnuA （x^2 = 14.57, P 〈 0.05）. SLEDAI scoring （score 〉 10） of SLE with positive and negative AnuA were 100% and 71%, respeetively（x^2 = 6.56, P 〈 0.05 ）. The positive AnuA in SLE with negative anti-dsDNA , antieardiolipin antibody were 32% and 25% respectively. Conclusion AnuA has a close correlation with the activity of children SLE and is a valuable marker in the diagnosis of child SLE.

关 键 词：抗核小体抗体 系统型红斑狼疮 

分 类 号：R725.9[医药卫生—儿科]