五种自身抗体在狼疮性肾炎患者诊断的意义  

Significance of five autoantibodies in patients with lupus nephritis

作　　者：钟路[1] 符克英[1] 陈汝[1] 黄白丽[1] 阮和球[1] 庞海云[1] 

机构地区：[1]海南省人民医院,海南海口570311

出　　处：《中国热带医学》2007年第12期2224-2225,共2页China Tropical Medicine

摘　　要：目的探讨抗核抗体(ANA)、抗可提取性抗原多肽抗体谱(ENA)、抗双链DNA抗体(dsDNA)、抗中性粒细胞胞浆抗体(ANCA)和抗心磷脂抗体(ACA)在狼疮性肾炎诊断及治疗中的意义。方法采用免疫荧光法测定ANA,蛋白芯片法测定ENA多肽抗体谱,金标法测定抗ds-DNA抗体,间接免疫荧光法测定ANCA,酶标法测定ACA,并对结果进行分析。结果狼疮性肾炎患者组这五项指标都高于正常对照组,二者显著有统计学意义(P<0.01),但这五项指标对SLE诊断的准确性、敏感性和特异性各不相同。结论ANA作为狼疮性肾炎最重要的一类抗体,可作为初筛指标,ENA7个位点抗体检测提高ANA的敏感性与特异性,dsDNA抗体可作为治疗监测的指标,ANCA对病情活动监测有意义,抗心磷脂抗体(ACA)是一种自身抗体,与其他自身抗体联合测定对于狼疮性肾炎的早期诊断、监测、治疗更有意义。Objective To discuss the significance of anti - nuclear antibodies（ANA）, Anti - brine extracted antigen peptide antibody spectrum（ENA）, Anti- dsDNA （dsDNA）, Anti- nentrophil cytoplasmic antibodies（ANCA）, Anti cardiolipin antibodies （ACA）, in diagnosis, monitoring and treatment of lupus nephritis . Methods Using immunotluorescence method ,ANA, protein chip ENA peptide antibody spectrum, colloidal gold labeled anti - dsDNA antibody were determined; ANCA was determined with indirect immunofluorescenee method, ACA was determined with ELISA. Results The five indicators in lupus nephritis patients in this group were higher thanthe normal controls, showing significant differences （ P 〈 0. 01）. Conclusion ANA as an principal antibody in lupus nephritis can taken as an indicator in initial screening. The detection of ENA at seven point can increase sensitivity and specificity in detection of ANA antibody, dsDNA antibody can be used as indicators for monitoring, ANCA is meaningful in monitoring of disease activity, ACA （ACA） is a self - antibodies, common in SLE and other autoimmune diseases and ACA is expressed differently in lupus nephritis patients and the joint detection of ACA is helpful fro early diagnosis, monitoring and treatment of lupus nephritis.

关 键 词：狼疮性肾炎 ANA ENA 抗双链DNA抗体 ANCA ACA 

分 类 号：R593.24[医药卫生—内科学]