SLE患者可提取核抗原检测及其与狼疮性肾炎的关系  

Clinical significance of extractable nuclear antigen (ENA) detection in SLE and relationship between ENA and LN

作　　者：王黎敏[1] 阳晓[1] 叶任高[2] 

机构地区：[1]深圳市蛇口人民医院内科,518067 [2]中山医科大学肾脏病研究所,510089

出　　处：《广东医学》1999年第10期757-759,共3页Guangdong Medical Journal

摘　　要：目的　探讨可提取核抗原(ENA)多肽抗体谱在SLE中的诊断价值及其抗Sm抗体与临床表现和血清学关系。方法　用免疫印迹技术检测345例SLE患者ENA多肽抗体谱,并将66例抗Sm、抗ds-DNA阳性患者的临床表现和血清学特征与98例阴性患者进行比较。结果　①345例SLE患者ENA多肽抗体总阳性率为478%,其中抗Sm35.9%、抗RNP310%、抗Rib4.6%、抗-SSA290%、抗-SSB272%。②抗Sm阳性组关节炎、蝶形红斑、脱发、肺及胸膜病变显著高于阴性组;抗Sm与抗RNP、抗-SSA、抗-SSB、抗Rib关系密切;但两组间肾损害及狼疮活动指数无差异。结论　①免疫印迹技术检测ENA多肽抗体对SLE早期诊断有较高特异性及敏感性。②抗Sm与关节炎、内脏、皮肤损害、脱发有关。Objective To investigate the diagnostic value of antibodies of extractable neclear antigen (ENA) in systemic lupus erythematosus (SLE) and relationship between anti-Sm antibody and clinical characteristics and serology of lupus nephritis (LN). Methods Serum antibodies to ENA were detected with immunoblotting technique in 345 SLE patients. Clinical and serological charaeteristics of 66 SLE patients with positive of anti-Sm and anti-ds-DNA test were reviewed and compared to that of 98 anti-Sm negative counterparts. Results ①Total positive rate of ENA antibodies was 47 8%(165/345). The positive rates of anti-Sm, anti-RNP, anti-SSA, anti-SSB and anti-Rib were 35 9% (124/345), 31 0%(107/345), 29 0%(100/345),27 2%(94/345) and 4 6%(16/345), respectively. ②The incidences of arthritis, malarrash, alopecia lung and pleura lesions were more common in anti-Sm positive group than in anti-Sm negative group, anti-Sm was found to be correlated to anti-RNP, SSA, SSB, and Rib. However, no differences in renal involvement were found. Conclusion ① ENA antibodies have high sensitivity and specificity in early diagnosis of SLE. ②Anti-Sm is one of the important markers of SLE. Anti-Sm is associated with arthritis, viceral involvement, severe skin lesions and alopecia. Anti-Rib is probably another important index for the diagnosis of SLE.

关 键 词：可提取核抗原 系统性红斑狼疮 狼疮性肾炎 

分 类 号：R593.241[医药卫生—内科学] R593.242[医药卫生—临床医学]