AnuA﹑抗dsDNA及抗C1q抗体在系统性红斑狼疮及狼疮肾炎诊断中的作用  

Significance of autoantibodies in the diagnosis of systemic lupus erythematosus and lupus nephritis

作　　者：吴东海[1] 祖宁[1] 张荣富[1] 

机构地区：[1]中日友好医院风湿免疫科,北京100029

出　　处：《中日友好医院学报》2007年第1期5-8,共4页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨抗核小体抗体(AnuA)、抗dsDNA及抗C1q抗体在系统性红斑狼疮(SLE)及狼疮肾炎(LN)诊断中的价值。方法:采用酶联免疫吸附法检测SLE患者(n=88)、疾病对照组(n=59)和正常对照组(n=48)血清中的AnuA、抗dsDNA及抗C1q抗体阳性率,并与SLE患者临床实验室指标﹑活动性评分及LN的病理分型进行相关性分析。结果:AnuA﹑抗dsDNA及抗C1q抗体的阳性率在SLE患者中为67.05%、77.27%、68.18%,均显著高于疾病对照组和正常对照组患者(均P<0.05)。3种抗体与SLE患者C3、C4呈负相关(P<0.05),与血沉、C反应蛋白升高、补体下降呈正相关(均P<0.05)。3种抗体均与SLEDAI活动性评分呈正相关(P<0.01)。3种抗体对SLE诊断的特异性分别为77.97%、79.66%、74.58%,联合检测的特异性为89.83%。抗C1q抗体在狼疮增殖性肾炎(Ⅱ﹑Ⅲ﹑Ⅳ型LN)患者中表达明显高于膜性肾炎(Ⅴ型LN)的患者(P<0.05)。结论:AnuA﹑抗dsDNA及抗C1q抗体检测对SLE及LN的诊断和疾病活动性判断有重要价值。三抗体联合检测可增加SLE的诊断特异性。抗C1q抗体参与了狼疮增殖性肾炎的免疫发病机制,可能对LN的病理类型有一定的预测价值。Objective：To explore the significance of anfinueleosome （AnuA）,anti-dsDNA and anti-C1q antibodies in diagnosis of systemic lupus erythematosus and lupus nephritis （LN）.Methods：The enzyme linked immunosorbent assay （ELISA） was used to measure AnuA,anti-dsDNA and anti-C1q antibodies in sera of 88 SLE patients,among them 59 patients suffered with other rheumatic diseases （incuding primary Sjogren syndrome,dermatomyositis,polymyositis,rheumatoid arthritis,Bechet＇ s disease,Still＇ s disease,ankylosing spondylitis and systemic sclerosis）and 48 healthy controls.Results：Of the 88 SLE patients,67.05%,77.27%and 68.18% （P〈0.05）were seropositive for AnuA,anti-dsDNAand anti-C1q antibodies respectively.Of the 57 LN patients,73.68%,77.86%and 73.68% （P〈0.05）were seropositive for AnuA,anti-dsDNA and anti-C1q antibodies respectively.The titers of AnuA,anti-dsDNA and anti-C1q antibodies correlated with ESR,CRP and SLEDAI positively（P〈0.05,P〈0.01 ）and correlated with C3,C4 negatively.The specificity of ＂AnuA,antFdsDNA and anti- C1q antibodies for lupus were 77.97% ,79.66%and 74.58%.The specificity of combination of three antibodies for lupus was 89.83%.Anti-C1q antibodies were associated with the presence of proliferative glomerulonephritis （P〈0.05）.Conclusion：AnuA,Anti-dsDNA and anti-C1q antibodies are associated with SLE,LN and assessment of disease activity.Simultaneously detection is valuable in the diagnosis of lupus flare up.Anti-C1q antibodies may play a major role in the immunopathogenesis of renal nephritis.

关 键 词：抗DSDNA抗体 抗核小体抗体 抗C1Q抗体 系统性红斑狼疮 狼疮肾炎 

分 类 号：R593.24[医药卫生—内科学]