系统性红斑狼疮疾病活动性的血清学指标的评价  

Evaluation the significance of serum anti-nucleosome Ab,anti-C1q Ab and anti-dsDNA Ab in the activity of systemic lupus erythematosus

作　　者：金卫东[1] 贾敬年[1] 俞晓洁[1] 周永列[1] 

机构地区：[1]浙江省人民医院医学检验中心,浙江杭州310014

出　　处：《中国实验诊断学》2007年第9期1156-1159,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨抗核小体抗体(AnuA),抗C1q抗体和抗dsDNA抗体与系统性红斑狼疮(Systemic lupus erythemato-sus,SLE)活动性的关系。方法对33例狼疮肾炎(L nephritis,LN)患者血清进行检测抗核小体抗体,抗Clq抗体,抗ds-DNA抗体,以43例无肾炎临床表现的SLE患者做为对照组。同时将76例SLE患者按SLEDAI评分分为SLEDAI≥10分组与SLEDAI<10分组两组,进行抗核小体抗体,抗Clq抗体和抗dsDNA抗体与SLE活动度相关性的分析。结果LN患者血清中抗核小体抗体。C1q抗体浓和抗dsDNA抗体的阳性率显著高于非LN组(P<0.01),与SLE对照组比较差异也有统计学意义(P<0.05)。同时SLEDAI≥10分组,抗核小体抗体,抗C1q抗体和抗dsDNA抗体浓度及阳性率显著高于SLEDAI<10分组(P<0.01),3种抗体有较高的灵敏度,特异性。三者联合检测的灵敏度(66.7%),特异性(85.7%)。相关性分析表明血清中抗核小体抗体,抗C1q抗体和抗dsDNA抗体与SLEDAI评分呈正相关。分别以LN和SLEDAI作为因变量将抗核小体抗体,抗C1q抗体,抗dsDNA抗体,抗Sm抗体,抗nRNR抗体进行Logistic回归统计分析。结果显示以LN作为因变量入选的自变量有抗C1q抗体,抗Sm抗体(P<0.05),以SLEDAI作为因变量入选的自变量有抗核小体抗体,抗C1q抗体和抗dsDNA抗体(P<0.05)。结论在LN患者和SLEDAI≥10分组中,存在抗核小体抗体,抗C1q抗体和dsDNA抗体的高表达。3种血清标志物和SLE疾病的活动性密切相关。Objective To analyze the relationship between these auto-antibodies（anti-nucleosome, AntrA; anti-C1q; anti-dsDNA anti-bodies）with theacfivity of systemic lupus erythematosus Methods Examine anti-nucleosome antibodies, anfi-C1q antibodies and anti-dsDNA antibodies in the sere of 33 patients with LN and 43 patients of systemic lupus eryfhematosus without renal damage. Then apart all samples to two groups by SLEDAI to analyze the correlate between the coneentrat/on and disease activity. Results Anti-nucleosome antibodies, anti-C1q antibodies and anti-dsDNA antibodies were significantly higher in LN than in control（ P 〈 0.01）. and also higher than the normal group. The same phenomena exist the SLEDAI（ systemic lupus erythematosus disease activity index, SLEDAI）≥10 group. The thtree auto-antibodies have high sensitivity and specificity, the sensitivity and specificity of three auto-anfilbodies combined determination is 66.7% ,85.7% .These auto-antibodies level was positively correlated with the score of SLEDAI. In multivariate analysis the factors associate with LN and SLEDAI were anti-nrcleosome antibodies, anti-C1q antibodies, anti-ds DNA antibodies Conclusion in patients with LN or SLEDAI≥10 anti-nucleosome antibodies, ante-C1q antibodies and and anti-ds DNA antibodies are significantly higher than control groups. These antibodies are suggested to be diagnositc tools to reflect the activity systemic lupus erythematosus.

关 键 词：抗核小体抗体 抗C1Q抗体 抗DSDNA抗体 系统性红斑狼疮 狼疮肾炎 SLE疾病活动指数 

分 类 号：R593.241[医药卫生—内科学]