外周血清抗核小体抗体家族分子表达水平与SLE患者疾病活动度的关联研究  

Association of expression of serum antinucleosome antibody family and SLE disease activity index

作　　者：盛敏玲[1] 郝加虎[2] 陶金辉[1] 张宏[1] 张志华[2] 张国庆[2] 徐胜前[3] 钱浩[3] 戴宏[3] 

机构地区：[1]安徽省立医院,合肥230001 [2]安徽医科大学公共卫生学院,合肥230032 [3]安徽医科大学第一附属医院,合肥230022

出　　处：《中国卫生检验杂志》2013年第1期95-100,共6页Chinese Journal of Health Laboratory Technology

基　　金：安徽省自然科学基金(090413130)

摘　　要：目的:比较系统性红斑狼疮患者(systemic lupus erythematosus,SLE)和正常对照两组间的血清抗核小体抗体家族分子的表达水平;分析抗核小体抗体家族分子与SLE患者疾病活动度之间的关系,并探讨血清抗核小体抗体家族分子与患者器官/系统损害的关联是否涉及细胞凋亡。方法:病例来自两所三甲医院住院SLE患者,以健康志愿者为对照组;运用流式细胞术,采用连接素V和碘化丙啶双染法检测研究对象的外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)的早期凋亡率;以双抗夹心酶联免疫吸附实验测定研究对象外周血抗核小体抗体家族分子的表达水平。结果:SLE患者的血清抗核小体抗体、抗dsDNA抗体、抗组蛋白抗体阳性率分别为68.42%、53.95%、44.74%,而在正常对照组血清抗核小体抗体家族分子均为阴性。SLE非活动组(n=23)和活动组(n=53)患者的血清抗核小体抗体表达水平(分别为81.697±86.256 IU/ml、101.957±97.431 IU/ml)、抗dsDNA抗体(分别为266.881±366.684 IU/ml、286.483±279.298 IU/ml)、抗组蛋白抗体(分别为45.421±58.262 IU/ml、64.257±69.976 IU/ml)均高于正常对照组(n=69,分别为10.106±0.5348 IU/ml、20.034±12.075 IU/ml、9.290±1.281 IU/ml),三组间差异均有统计学意义(F=29.414,P=0.000;F=24.872,P=0.000;F=20.147,P=0.000)。但SLE患者非活动组和活动组的3种血清抗核小体抗体家族分子浓度差异均无统计学意义。仅发现抗组蛋白抗体与SLEDAI之间呈正相关(r=0.251,t=2.234,P=0.029)。多重线性回归分析结果表明,抗核小体抗体水平在临床上可作为SLE患者疾病活动度的监测参考指标;而对于活动期SLE患者,抗dsDNA抗体可较好地反映疾病活动度。结论:SLE患者血清抗核小体抗体家族分子的表达水平增加,且与患者的PBMCs的早期凋亡率呈正相关。抗核小体抗体水平在临床上可作为SLE患者疾病活动度的监测参考指标;而对于活动期SLE患者,抗dsD-NA�Objective：To compare the expression of the serum antinucleosome antibody family by enzyme-linked immunosorbent assay between the healthy controls and patients with systemic lupus erythematosus（SLE）,to analyze the relationship of the serum antinucleosome antibody family and the organ or system damage in SLE,and to define the role of apoptosis in the relationships.Methods： SLE inpatients were selected from two tertiary A-level hospitals,and normal healthy volunteers were recruited as controls.Annexin V（AV） and propidium iodide（PI） were used to detect the early apoptosis rate of peripheral blood mononuclear cells（PBMCs）.Serum soluble antinucleosome antibodies,anti-double-stranded DNA antibodies,and antihistone antibodies activities were assessed by Sandwich-enzyme-linked immunosorbent assay（ELISA）.Association of the expression of serum antinucleosome antibody family and SLEDAI in SLE patients was analyzed by a multiple linear regression.Results： The prevalence rates of antinucleosome antibody family in SLE patients and normal healthy controls were 68.42% and 0.00% for antinucleosome antibody,53.95% and 0.00% for anti-dsDNA antibody,44.74% and 0.00% for antihistone antibody,respectively.Higher levels of antinucleosome antibodies（81.697±86.256 IU/ml,101.957±97.431 IU/ml,respectively）,anti-dsDNA antibodies（266.881±366.684 IU/ml,286.483±279.298 IU/ml,respectively） and antihistone antibodies（45.421±58.262 IU/ml,64.257±69.976 IU/ml,respectively） were found in SLE patients of inactive group and active group compared with those in normal healthy controls（10.106±0.5348 IU/ml,20.034±12.075 IU/ml,9.290±1.281 IU/ml,respectively）.No significant difference of serum levels of antinucleosome antibodies,anti-dsDNA antibodies and antihistone antibodies were found in SLE patients between active group and inactive group..There was a positive correlation between the serum levels of antihistone antibodies and SLEDAI（r=0.251,t=2.234,P=0.029）.The multiple linear regression for the SLED

关 键 词：脱噬作用 红斑狼疮 系统性 抗核小体抗体家族 

分 类 号：R593.241[医药卫生—内科学]