抗心磷脂抗体、抗核小体抗体、补体联合检测在狼疮肾炎诊断中的应用  

Clinical Analysis of Anticardiolipin Antibodies,Anti-nucleosome Antibodies and Complement in Lupus Nephritis

作　　者：赵宏丽[1] 李桂珍[1] 赵俊芳[1] 李孟娟[1] 

机构地区：[1]天津市中医药研究院附属医院,天津300120

出　　处：《中国中西医结合皮肤性病学杂志》2012年第3期146-148,共3页Chinese Journal of Dermatovenereology of Integrated Traditional and Western Medicine

摘　　要：目的比较抗心磷脂抗体(anticardiolipin antibody,ACA)、抗核小体抗体(anti-nucleosome antibody,AnuA)、抗ds-DNA抗体、抗Sm抗体、免疫球蛋白、补体在狼疮肾炎中的诊断价值。方法采用酶联免疫吸附法检测抗心磷脂抗体,线性免疫分析法检测抗核小体抗体、抗Sm抗体,间接免疫荧光法检测抗ds-DNA抗体,免疫散射比浊法检测免疫球蛋白及补体。结果 ACA、AnuA、抗-dsDNA抗体阳性率在狼疮肾炎组明显高于无肾脏表现组,而且2组患者之间比较差异有统计学意义(P<0.05),而抗Sm抗体在2组患者之间比较差异无统计学意义(P>0.05)。IgG水平在狼疮肾炎组和无肾脏表现组均高于对照组(P<0.05),而且狼疮肾炎组和无肾脏表现组比较也有统计学意义(P<0.05);补体C3、C4水平在狼疮肾炎组和无肾脏表现组均低于对照组(P<0.05),而且狼疮肾炎组和无肾脏表现组比较也有差异统计学意义(P<0.05)。狼疮肾炎患者ACA、AnuA、抗-dsDNA、IgG、C3、C4 6项指标的阳性率比较差异无统计学意义(χ2=9.099,P>0.05)。结论 ACA、AnuA、抗-dsDNA、IgG、C3、C4均可以反映SLE患者有肾脏损伤,但是由于作用机制各不相同,此6项指标间无相关性,联合检测可以显著提高狼疮肾炎的确诊率,为早期治疗提供实验室依据。Objective To contrast diagnostic value of anticardiolipin antibodies （ACA）, anti-nucleosome antibodies （AnuA）, anti-Sm antibodies, and anti-double stranded DNA antibodies, immunoglobulin and complement in lupus nephritis （LN）. Methods Enzyme-linked immuno sorbent assay （ELISA） was used to detect ACA; immuno-scatter turbidmetry was used to assay immunoglobulin and complement; indirect immunoflurescence （IIF） was used to assay anti-double stranded DNA antibodies; and linear immune analysis （LIA） method was used to assay anti-Sm antibodies and AnuA. Results The positive ratio of AnuA, ACA, anti-dsDNA, anti-Sm was higher in LN group than that of non-nephritis group. But anti-Sm had no statistical significance. The level of IgG in LN group was higher than that in non-nephritis group, and the level of C3 and C4 are lower in lupus nephritis group （P〈0.05）. Chisquare test was used to contrast positive ratio of ACA, AnuA, anti-dsDNA, IgG, C3 and C4. The results had no statistical significance. Conclusion ACA, AnuA, anti-dsDNA, IgG, C3 and C4 might also indicate kidney injury. But there has no correlation, because their pathogenesis is different. The six index united detection could greatly improve the positive rate, which provides experiment base for early treatment.

关 键 词：抗心磷脂抗体 抗核小体抗体 补体 狼疮性肾炎 

分 类 号：R593.24[医药卫生—内科学]