联合检测C_1q抗体、双链DNA抗体对系统性红斑狼疮的诊断价值  

Significance of combination of serum C_1q antibody and dsDNA antibody in systemic lupus erythematosus.

作　　者：汪国生[1] 钱龙[1] 张宏[1] 单曙光[1] 杨国俊[1] 王玮[1] 厉小梅[1] 李向培[1] 

机构地区：[1]安徽医科大学附属省立医院安徽省立医院风湿科,合肥230001

出　　处：《中国综合临床》2006年第5期411-414,共4页Clinical Medicine of China

基　　金：安徽省临床医学重点学科技术进步专项课题(2004Z003)

摘　　要：目的探讨联合检测C1q抗体、双链DNA(dsDNA)抗体对狼疮活动和狼疮性肾炎的价值。方法58例系统性红斑狼疮分为疾病活动和疾病稳定组、狼疮性肾炎和非狼疮性肾炎组,酶联免疫吸附法检测血清C1q抗体和dsDNA抗体水平,比较两抗体单个和联合检测对疾病活动和狼疮性肾炎的价值。结果C1q抗体和dsDNA抗体阳性对疾病活动的敏感性分别为63.88%和69.44%,特异性分别为81.82%和86.36%;两抗体联合对疾病活动的敏感性为83.33%,特异性为72.73%,两抗体的一致率为70.68%。疾病活动组两抗体阳性率和抗体水平显著高于疾病稳定组;两抗体与系统性红斑狼疮疾病活动指数、血沉、IgG、球蛋白水平显著正相关,与C3、C4及白蛋白水平显著负相关。狼疮性肾炎组dsDNA水平显著高于非狼疮性肾炎组,尿蛋白≥(++)患者C1q抗体水平显著增高。结论C1q抗体和dsDNA抗体都是狼疮疾病活动的指标,两抗体都与狼疮性肾炎有关,联合检测可以提高疾病活动检出率。Objective To explore the value of C1 q antibody and dsDNA antibody combination detection in systemic lupus erythematosus （SLE） activity and lupus nephritis. Methods 58 SLE patients were divided into active and stable groups,lupus nephritis and non lupus nephritis groups. Anti-C1 q and anti-dsDNA Abs were detected at the same time in 58 SLE patients using ELISA. The values of C1q antibody and dsDNA antibody combination detection and the detcction of thc single antibody to the disease activity and lupus nephritis were compared. Results The scnsitivity and specificity of anti-C1 q and anti-dsDNA Abs in lupus active patients were 63.88% and 69.44%, 81.82% and 86.36% respectively. The sensitivity and specificity of combination of two antibodies were 83.33% and 72.73%. Coincidcncc rate of anti-C1 q and anti-dsDNA was 70.68%. The positive rate and scrum level of two antibodies in lupus flarc-up group were greater than those in stable group. Two antibodies were positively correlated with SLEDAI ,erythrocyte sedimentation rate （ESR）, IgG and globulin but negatively correlated with serum level of C3 ,C4 and albumin. Serum level of anti-dsDNA in lupus nephritis group was higher than that in non lupus nephritis group. Serum levels of anti-C1q in patients with proteinuria ≥ （ ＋ ＋ ） were significantly increased. Conclusion Anti-C1 q and anti-dsDNA are two important indicators of systemic lupus erythematosus activity, and are correlated with lupus nephritis. Combination detection of the two antibodies may promote the detection rate of disease activity.

关 键 词：系统性红斑狼疮 C1Q抗体 双链DNA抗体 

分 类 号：R593.241[医药卫生—内科学]