抗细胞膜DNA抗体对系统性红斑狼疮的诊断价值及与其他抗体联合检测的意义  

The detection of DNA-associated autoantibodies to cell membrane and its combination with other autoantibodies in the diagnosis of systemic lupus erythematosus

作　　者：魏华[1] 吕志勤[1] 茹晋丽[1] 李小峰[1] 许珂[1] 温鸿雁[1] 

机构地区：[1]山西医科大学第二医院风湿免疫科,太原030001

出　　处：《中华风湿病学杂志》2010年第3期185-187,218,共4页Chinese Journal of Rheumatology

摘　　要：目的探讨抗细胞膜DNA（mDNA）抗体在系统性红斑狼疮（SLE）患者的表达以及该特异性抗体对SLE患者的诊断价值及与其他抗体联合检测的意义。方法用间接免疫荧光法观察培养的HL60细胞的特异性细胞膜的荧光图形，以细胞周连续的环状荧光为抗mDNA抗体阳性。同时检测SLE的其他常见抗体，采用peamonr检验进行统计学处理。结果抗mDNA抗体在205例SLE患者中有145例阳性，阳性率70．7％，在55例类风湿关节炎（RA）患者中5例阳性，阳性率为9．1％，45例原发性干燥综合征（pSS）患者中10例阳性，阳性率为22．2％，35例皮肌炎／多肌炎（PM／DM）患者中4例阳性，阳性率14．3％，50名健康对照组中均为阴性。抗mDNA抗体对SLE诊断的敏感性为70．7％，特异性为86．7％。抗mDNA抗体阳性＋抗核抗体（ANA）阳性联合检测的敏感性94．6％，特异性76．7％；抗mDNA抗体阳性＋抗双链DNA（dsDNA）抗体阳性联合检测的敏感性76．8％，特异性95．5％；抗mDNA抗体阳性＋抗Sm抗体阳性联合检测的敏感性79．6％，特异性100％；抗mDNA抗体阳性＋抗核小体抗体（AnuA）阳性联合检测的敏感性93．0％，特异性100％。结论抗mDNA抗体是一种诊断SLE的新的标记抗体，其敏感性较高，特异性强，较抗dsDNA抗体、抗Sm抗体检测更先进。与SLE常用其他抗体联合检测可进一步提高敏感性和特异性。Objective To evaluate the diagnostic value of autoantibodies to cell membrane associated with DNA （mDNA） in systemic lupus erythematosus （SLE） and the combination with other autoantibodies in the diagnosis of SLE. Method The anti-mDNA antibody had the characteristic pattern of perip-heral membrane fluorescence on cultured HL60. The same serum samples were detected for other antibo-dies of SLE. Pearson＇s Chi-square test was used for statistical analysis. Results This pattern was observed in 145 of 205 serum samples of SLE patients , but in 5 of 55 the serum samples of rheumatoid arthritis , in 10 of 45 primary Sj0gren syndrome＇s patients and in 4 of 35 PM/DM and absent in 50 blood donors. The sensitivity and specificity of anti-mDNA antibody to SLE was 70.7% and 86.7%. The sensitivity and specificity of combined anti-mDNA antibody and ANA was 94.6% and 76.7%. The sensitivity and specificity of combined anti-mDNA antibody and anti-dsDNA antibody was 76.8% and 95.5%. The sensitivity and specificity of combined antimDNA antibody and anti-Sin antibody was 79.6% and 100%： The sensitivity and specificity of combined anti- mDNA antibody and AnuA was 93.0% and 100%. Conclusion This novel rapid immunofluoreseence method can be a useful diagnostic test for SLE patients. Due to its high sensitivity and specificity, it is better than other diagnostic tests such as anti-dsDNA antibody and anti-Sin antibody for the diagnosis of SLE.

关 键 词：红斑狼疮 系统性 自身抗体 抗体 抗核 

分 类 号：R593.241[医药卫生—内科学]