2种方法检测抗双链DNA抗体的比较及临床意义  

Comparison and clinical significance of two detection methods of anti-dsDNA antibody

作　　者：张宏[1] 汪国生[1] 李向培[1] 马艳[1] 

机构地区：[1]安徽医科大学附属省立医院风湿免疫科,合肥230001

出　　处：《安徽医学》2012年第11期1430-1432,共3页Anhui Medical Journal

基　　金：安徽省教育厅自然科学基金(项目编号:KJ2009B072)

摘　　要：目的探讨CL-IIF法和ELISA法单独及联合检测抗双链DNA(ds-DNA)抗体异同,了解2种方法联合检测在系统性红斑狼疮(SLE)中的诊断及临床应用价值。方法 77例SLE患者分为疾病活动组和疾病稳定组,另选择49例疾病对照、35例正常人血清对照,各组年龄和性别差异无统计学意义。利用2种方法检测其血清中抗ds-DNA抗体,每种方法使用2个厂家的试剂,比较不同方法之间、同一种方法不同厂家试剂之间以及SLE不同阶段之间的敏感性和特异性。结果每种方法的不同厂家试剂之间检测结果差异无统计学意义(P>0.05)。CL-IIF法和ELISA法在SLE中的敏感性分别为55.8%和70.1%,特异性分别为100.0%和92.9%。两种方法在SLE中的敏感性均明显高于疾病对照组及健康对照组,差异有统计学意义(P<0.05)。在检测SLE疾病活动组抗ds-DNA抗体中,CL-IIF法和ELISA法的阳性率分别为97.5%和95%;而在SLE疾病稳定组阳性率分别为10.8%和27%,2组差异有统计学意义,在SLE疾病活动组中特异性分别为89.2%和73.0%。同时,ELISA法检测出正常对照及疾病对照组、SLE稳定组和SLE活动组3组之间的抗ds-DNA抗体浓度均数差异有统计学意义,SLE疾病活动度与抗ds-DNA抗体的浓度呈线性趋势(P<0.05)。结论 CL-IIF法检测SLE中的抗ds-DNA抗体具有很高的特异性,但敏感性较低,尤其在疾病稳定期中。CL-IIF法价格便宜,适于SLE的确诊。ELISA法可定量检测抗ds-DNA抗体的浓度,且其浓度与SLE疾病活动度呈线性相关,适于监测SLE患者的病情,并进行疗效评价。Objective To compare efficiencies of CL-IIF,ELISA detection anti-dsDNA antibody by single or combination,and to investigate the diagnostic and applicable value of combined detection in systemic lupus erythematosus.Methods Seventy-seven cases of SLE were divided into active and stable stage group.Another 49 disease and 35 healthy adults were selected as healthy controls.The serum anti-dsDNA antibody was detected with two methods,and their respective sensitivity and specificity were compared.Results The sensitivity of CL-IIF and ELISA in diagnosing SLE was 55.8% and 70.1% respectively,higher than that of disease control group and healthy control group.When each of the two methods was applied to test active SLE,the sensitivity was 97.5% and 95.0% respectively.As far as stable cases concerned,the sensitivity was 10.8% and 27.0% respectively,and the specificity was 89.2% and 73.0% in cases of SLE,and the difference had statistical significance.Meanwhile in anti-dsDNA antibody concentration means with ELISA method to detect showed statistically significant differences among these groups（P〉0.05）.Conclusion CL-IIF has a high specificity in diagnosing SLE,but the sensitivity is low,especially in stable period of SLE.CL-IIF is low cost,and is suitable for SLE diagnosis.ELISA can detect anti-dsDNA antibody concentration quantitatively.We found that anti-dsDNA antibody concentration is linearly related with SLE activity,which is suitable for monitoring the condition of SLE and evaluating curative effects.

关 键 词：抗双链DNA抗体 酶联免疫吸附试验 间接免疫荧光法 

分 类 号：R440[医药卫生—诊断学]