抗增殖细胞核抗原抗体在系统性红斑狼疮中的临床意义  

Clinical significance of antibody to proliferating cell nuclear antigen in patients with systemic lupus erythematosus

作　　者：王静[1,2] 陈进伟[1] 高洁生[1] 李芬[1] 田静[1] 杜金烽[1] 谢希[1] 毛妮[1] 吴佩君[1] 

机构地区：[1]中南大学湘雅二医院风湿免疫科,长沙410011 [2]云南省第一人民医院风湿免疫科

出　　处：《中华风湿病学杂志》2012年第10期684-687,共4页Chinese Journal of Rheumatology

摘　　要：目的探讨抗增殖细胞核抗原（PCNA）抗体在系统性红斑狼疮（SLE）中的诊断价值与意义。方法对102例抗PCNA抗体阳性患者与临床疾病的关系进行回顾性分析，并采用线性免疫分析法对536例SLE患者抗PCNA抗体进行检测，分析抗PCNA抗体在SLE中的阳性率及抗PCNA抗体与SLE临床表现、疾病活动和其他自身抗体的关系。采用t检验和r检验进行统计学分析。结果102例抗PCNA抗体阳性患者中SLE49例（48．0％），原发性干燥综合征25例（24．5％），系统性硬化13例（12．7％），原发性胆汁性肝硬化4例（3．9％），多肌炎，皮肌炎2例（2．0％），自身免疫性甲状腺炎7例（6．9％），丙型病毒性肝炎1例（1．0％）。抗PCNA抗体在SLE中的阳性率为9．1％。抗PCNA抗体阳性患者出现皮疹、雷诺现象、神经精神狼疮、肾脏受累的发生率及SLE疾病活动度评分（SLEDAI）明显高于抗PCNA抗体阴性患者，差异有统计学意义（R0．05）。抗PCNA抗体阳性组抗Rib—P、抗dsDNA抗体、抗R052、抗RNP／Sm抗体的阳性率明显高于抗PCNA抗体阴性组，差异有统计学意义（P〈0．05）。结论抗PCNA抗体并非SLE所特有，可在多种疾病中出现。抗PCNA阳性的SLE患者更易出现皮疹、雷诺现象、神经精神狼疮和肾脏受累，与疾病活动相关。抗PCNA抗体伴抗Rib-P、抗dsDNA、抗R052、抗RNP／Sm抗体的阳性率升高。Objective To study the clinical significance and diagnostic value of anti-proliferating cell nuclear antigen （PCNA） antibodies. Methods A retrospective analysis was conducted for the diagnoses and clinical features of 102 patients with anti-PCNA antibodies. Line immunoassay was used to detect anti-PCNA antibody of 536 systemic lupus erythematosus （SLE） patients. Possible relationship between anti-PCNA anti- body and clinical features and other antibodies in SLE were analyzed. Comparisons between groups were performed by t-test orAA test. Results In the 102 patients with anti-PCNA antibodies, 49 had SLE （48.0%）. Other disorders associated with anti-PCNA antibodies included primary Sjisgren＇s syndrome（ 24.5% ）, systemic sclerosis （ 12.7% ）, primary biliary cirrhosis （ 3.9% ）, auto-immune thyroiditis （ 6.9% ）, polymyositis/derm- atomyositis （2.0%） and hepatitis C virus infection （1.0%）. 9.1% of SLE patients showed positive anti-PCNA antibody. Compared with those SLE patients with negative anti-PCNA antibody, the occurrences of rash, neuropsychiatric SLE, renal involvement was significantly higher in the anti-PCNA positive patients. In addi- tion, the SLEDAI score was significantly higher in the latter. The positive rates of anti-Rib-P, anti-dsDNA, anti-Ro52, anti-RNP/Sm were higher in patients of SLE with positive anti-PCNA antibody. Conclusion Sera anti-PCNA antibody is not specific for SLE and it is associated with the occurrences of rash, Raynaud＇s phenomenon, neuropsyehiatric SLE, renal involvement and positive rates of anti-Rib-P, anti-dsDNA, anti- Ro52, anti-RNP/Sm. In addition, anti-PCNA antibody is associa-ted with the disease activity of SLE.

关 键 词：红斑狼疮 系统性 增殖细胞核抗原 抗增殖细胞核抗原抗体 

分 类 号：R593.241[医药卫生—内科学]