多种自身抗体联合检测对系统性红斑狼疮的诊断价值及意义  

Clinical significances of combined detections of autoantibodies in patients with systemic lupus erythematosus

作　　者：李俊[1] 罗娇[1] 徐巍[1] 张晓雪[1] 袁兆林[1] 沈波[1] 

机构地区：[1]浙江省台州医院检验科,浙江临海317000

出　　处：《浙江大学学报（医学版）》2010年第4期390-394,共5页Journal of Zhejiang University(Medical Sciences)

摘　　要：目的:通过对系统性红斑狼疮(SLE)患者的抗核抗体(ANA)、抗核抗体谱(ANAs)及抗双链DNA抗体(dsDNA)的检测,评价这些自身抗体对SLE的诊疗价值,为临床提供诊断、治疗的依据。方法:选择SLE组患者90例、疾病对照组患者74例和正常对照组患者53例,采用间接免疫荧光法测定ANA,免疫印迹法测定ANAs,放射免疫法测定抗ds-DNA,对所选患者血清标本进行检测,并对结果进行回顾性分析。结果:SLE患者的抗dsDNA、AnuA、抗Sm敏感性为41.1%、32.2%、22.2%,特异性均为97.3%,阳性似然比分别为15.22、11.93、8.22,三者联合检测敏感性达到62.2%,特异性达到90.5%。结论:抗dsDNA、AnuA、抗Sm是SLE的诊断性标记抗体,特异性高,但敏感性低,联合检测可以避免因单项检测出现的漏诊,提高对SLE诊断的敏感性和诊断效率。Objective： To evaluate the clinical significances of combined detections of the autoantibodies ANA,ANAs and anti-dsDNA in patients with systemic lupus erythematosus（SLE）.Methods： ANA was tested by indirect immnnofluorescent method（IIF）,ENA was tested by Western blot and anti-dsDNA was measured with radioimmunoassay in the serum samples from patients with SLE（n=90）,and from the comparison group（n=74） and healthy control group（n=53）.Results： The sensitivity of anti-dsDNA,AnuA,anti-Sm in patients with SLE was 41.1%,32.2% and 22.2%.The specificity of anti-dsDNA,AnuA,anti-Sm in SLE patients was all 97.3%.The positive likelihood ratios were 15.22,11.93 and 8.22,respectively.The sensitivity and specificity reached 62.2% and 90.5%,respectively by combined determinations of anti-dsDNA,AnuA and anti-Sm.Conclusions： The combined examinations of anti-dsDNA,AnuA,anti-Sms can improve the sensitivity and efficiency of laboratory diagnosis of SLE.

关 键 词：红斑狼疮 系统性/诊断 红斑狼疮 系统性/血液 DNA/免疫学 自身抗体 疾病活动性 

分 类 号：R593.241[医药卫生—内科学]