系统性红斑狼疮活动期与其伴新月体肾炎患者抗中性粒细胞胞浆抗体检测的临床意义  

Cfinical significance of nti-neutrophil cytoplasmic antibody test in active lupus and lupus patients compficated with crescentic glomerulonephritis

作　　者：姚文丽[1] 刘燕婕[2] 

机构地区：[1]湖北省天门市第一人民医院检验科,431700 [2]华中科技大学协和医院检验科

出　　处：《中国医药》2009年第12期982-983,共2页China Medicine

摘　　要：目的探讨抗中性粒细胞胞浆抗体（ANCA）在系统性红斑狼疮（SLE）活动期和在狼疮伴新月体肾炎诊断中的意义。方法采用间接免疫荧光（IIF）法和免疫印迹法分别测定132例SLE患者，其中59例为SLE稳定期、73例为SLE活动期患者的ANCA和SLE活动期相关自身抗体：抗ds—DNA抗体、AnuA和His，分析ANCA与SLE活动期相关自身抗体和狼疮疾病活动指数之间的关系，同时分析ANCA阳性的SLE患者伴新月体肾炎的发病率。结果ANCA在SLE活动期的阳性率为30．1％，且均为PANCA，并显著高于SLE稳定期（P〈0．05）。ANCA在SLE活动期阳性率与SLE活动期相关自身抗体dsDNA、AnuA和His的阳性率呈成正相关。ANCA阳性患者中的SLE活动指数（SLEDAI）与ANCA阴性组相比，差异有统计学意义（P〈0．05）。在ANCA阳性的29例SLE患者中，病理切片显示有17例伴新月体肾炎（58．6％），103例ANCA阴性患者中，伴新月体肾炎20例（19．4％），ANCA阳性组中伴新月体肾炎发病率明显高于阴性组（P〈0．01）。结论ANCA对判断狼疮活动性有一定的临床应用价值，对诊断SLE伴新月体肾炎有较为重要的临床意义。Objective To explore the significance of Anti-neutropil cytoplastnic antibady （ANCA） in the diagnosis of active phase of Systemic lupus erythematosus（SLE） and SLE complicated with crescentic glomeru-lonephritis. Methods To detect autoantibodies （the anti- ds DNA antibody, ANCA and His ） related to the active phase of SLE and the ANCA of 132 SLE patients with Indirect immunofluorescence（IFE） and Western-bloot methods. Fifty-nine cases were in stationary phase and 73 were in active phase. Relations among the ANCA and the- active phase of SLE related autoantibodies and SLE activation index were analyzed. Results The positive rate of ANCA in the active stage of SLE was 30.1%, higher than that in the stationary phase（P 〈0.05）. All ANCA was Perinuclear anti-neutrtphil cytoyasmic antibody（PANCA）. The positive rate of ANCA in the active stage are positively related to the positive rate of the active phase of SLE related autoantibodies which includs anti-ds- DNA antibody, AnuA and his. There was a remarkable diffrence（P 〈 0.01 ） between ANCA-positive SLE patients and ANCA-negative group within the indexes of SLEDAI. Seventeen of 29 ANCA（ ＋ ） SLE patients had complications of crescentic glomerulonephritis（ 19.4% ） and 20of 103 ANCA（ - ） SLE patients had crescentic glomerulonephritis. In SLE patients, the incidence of crescentic glomerulonephritis in ANCA （ ＋ ） group was different from that of ANCA （ - ） group （P 〈0.01）. Conclusion ANCA is of value for detection of SLE activity and complication of SLE.

关 键 词：抗中性粒细胞胞浆抗体 新月体肾炎 狼疮活动期 

分 类 号：R593.24[医药卫生—内科学]