IgG抗体亲和力指数在HCMV感染的SLE患者中的临床评估  

Clinical Evaluation of Human Cytomegalovirus Specific IgG Avidity Index in Systemic Lupus Erythematosus Patients

作　　者：张园[1,2] 潘阳[1,2] 李文丽[1,2] 张括[2] 王露楠[2] 

机构地区：[1]北京协和医学院研究生院,100730 [2]卫生部北京医院卫生部临床检验中心,100730

出　　处：《医学研究杂志》2012年第11期40-43,共4页Journal of Medical Research

摘　　要：目的用外周血人巨细胞病毒(HCMV)IgG抗体亲和力指数判断人巨细胞病毒在系统性红斑狼疮患者中感染的情况。方法间接酶联免疫吸附剂测定法(ELISA)检测122例系统性红斑狼疮患者,85例非系统性红斑狼疮的自身免疫病患者,137例正常人血清中人巨细胞病毒特异性抗体IgM和IgG,并对人巨细胞病毒IgG阳性的血清样本进行IgG抗体亲和力指数(a-vidity index,AI)的检测。结果系统性红斑狼疮患者人巨细胞病毒IgM抗体阳性率为11.48%;IgG抗体阳性率95.08%,其中低亲和力样本占8.62%。非系统性红斑狼疮自身免疫病患者血清中IgM抗体阳性率为1.18%;人巨细胞病毒IgG抗体阳性率95.29%且均为高亲和力抗体。而在137例正常样本中未检测到人巨细胞病毒IgM抗体阳性的样本;IgG抗体阳性率93.43%全部为高亲和力抗体。SLE患者相比非系统性红斑狼疮的自身免疫患者和正常人,其人巨细胞病毒IgM阳性率显著升高,且人巨细胞病毒IgG抗体低亲和力样本在IgG阳性样本中的比例也显著升高。因此,系统性红斑狼疮中的人巨细胞病毒初次感染后期[IgM(-)/IgG(+);AI<45%](10例)和再次或复发感染[IgM(+)/IgG(+);AI>55%](14例)的比例比非系统性红斑狼疮的自身免疫病患者和正常人都显著增多。结论综合HCMV IgG亲和力指数与HCMV IgM的检查结果发现,SLE患者相比正常人或非SLE自身免疫患者,表现出显著上升的原发性HCMV活化感染率与继发性HCMV活化感染率。因此,SLE的罹患与HC-MV感染有密切关联。Objective To investigate the action of HCMV IgG antibodies avidity index in SLE patients. Methods HCMV - IgM and HCMV - IgG of 122 SLE patients, 85 AD - except - SLE patients, and 137 normal controls were studied by ELISA essay, and HCMV - IgG antibodies avidity index of IgG positive subjects were measured. Results The present study showed that in SLE patients, 102 sub- jects were found HCMV - IgM negative and HCMV - IgG positive, 6 subjects were found HCMV - IgM negative and HCMV - IgG nega- tive, and 14 subjects were found HCMV -IgM positive and HCMV -IgG positive. On the contrary, in AD -except -SLE patients, 80 subjects were found HCMV - IgM negative and HCMV - IgG positive, 4 subjects were found HCMV - IgM negative and HCMV - IgG neg- ative, and only one subject was found HCMV - IgM positive and HCMV - IgG positive. In normal controls, 128 subjects were found HC- MV - IgM negative and HCMV - IgG positive, and 9 subjects were found HCMV - IgM negative and HCMV - IgG negative. After detec- ting the HCMV - IgG antibodies avidity index in subjects with HCMV - IgG positive, we discovered that in all SLE patients, 8.2% were assessed as primary active infection, 11.5% were assessed as secondary active infection, and 75.4% were assessed as latent infection. Therefore, the incidence of active HCMV infection in SLE patients was higher than in other AD （not including SLE） patients or normal controls. Conclusion Taken together, compared to normal controls and non - SLE autoimmune patients, SLE patients showed a higher proportion of active HCMV infection. Thus, the onset of SLE is closely correlated with HCMV activation.

关 键 词：巨细胞病毒 亲和力指数 系统红斑狼疮 自身免疫病 

分 类 号：R512.990.4[医药卫生—内科学]