自身抗体联合检测对系统性红斑狼疮诊断价值的评估  

The Evaluation of Joint Autoantibodies' Detection in the Diagnosis of Systemic Lupus Erythematosus

作　　者：沈莉[1] 康琼英[1] 沈扬[2] 宣晓梅[3] 李宝琴[1] 王立芹[4] 魏从真[1] 

机构地区：[1]河北医科大学第一医院检验科,河北石家庄050031 [2]河北医科大学第一医院血液科,河北石家庄050031 [3]河北医科大学第一医院皮肤科,河北石家庄050031 [4]河北医科大学流行病与卫生统计学教研室,河北石家庄050011

出　　处：《中国皮肤性病学杂志》2013年第9期938-941,共4页The Chinese Journal of Dermatovenereology

摘　　要：目的评估自身抗体联合检测对系统性红斑狼疮(SLE)的诊断价值。方法将实验人群分为3组,即系统性红斑狼疮(SLE)组、其他自身免疫病(OAID)组和正常对照(NC)组。3组采用间接免疫荧光(IIF)法、定量酶联免疫吸附(ELISA)试验及线性免疫检测(LIA)法分别检测抗核抗体(ANA)、抗双链DNA抗体(抗dsDNA抗体)、14种特异性IgG类自身抗体,并筛选出5种SLE相关自身抗体。从实验敏感性、特异性和Youden指数三个方面评估单项自身抗体检测及其联合检测对SLE的诊断价值。结果 SLE组ANA阳性率与OAID组相比差异无统计学意义(P>0.05);抗dsDNA,nRNP/Sm,Sm,ARPA,AnuA抗体阳性率明显高于OAID组(P<0.01);抗Histone抗体阳性率高于OAID组(P<0.05)。自身抗体联合检测的敏感性、正确诊断指数明显高于单项自身抗体的检测(P<0.01),特异性与单项自身抗体检测无明显差异(P>0.05)。结论抗dsDNA,Sm,ARPA,AnuA和Histone抗体是SLE诊断的重要指标。自身抗体联合检测可明显提高SLE诊断的敏感性和正确诊断指数,降低临床对SLE诊断的误诊率。Objective To evaluate the diagnostic value of joint autoantibodies＇ detection in the diagnosis of systemic lupus erythematosus（SLE）. Methods There were three groups in this experiment, namely the systemic lupus erythematosus（SLE） group, other autoimmune diseases（OAID） group and normal control（NC） group. In these three groups, indirect immunofluorescence（IIF） method, quantitative ELISA test and linear immunoassay（LIA） were used to detect ANA, anti-dsDNA and fourteen kinds of specific autoantibodies respectively. Five kinds of specific autoantibodies related to SLE were screened. The detection of single autoantibody and joint detection were valned in diagnosis of SLE from the aspects of the experimental sensitivity, specificity and Youden index. Results The positive rate of ANA in SLE group wasn＇t significantly different compared with that in OAID group（P 〉0.05 ）. The positive rate of anti-dsDNA, anti-nRNP/Sm, anti-Sm, ARPA, AnuA antibody in SLE group were obviously higher than that of OAID group（P 〈 0.01 ）. The positive rate of anti-histone antibody was higher than that of OAID group（ P 〈 0.05 ）. The experimental sensitivity and Youden Index of the joint autoantibodies＇ detection were obviously higher than that of single autoantity and Youden Index of the joint autoantibodies＇ detection were obviously higher than that of single autoantibody detection（P 〈 0. 01 ）. There was no significantly different in the experimental specificity between the combined detection and the single autoantibody detection（ P 〉 0.05 ）. Conclusion Anti-dsDNA, anti-Histone, anti-Sm, AnuA and ARPA were the important indicators in the diagnosis of SLE. Joint detection can significantly increase the experimental sensitivity and Youden Index in the diagnosis of SLE and then reduce the clinical misdiagnosis rate of SLE.

关 键 词：自身抗体 联合检测 诊断 系统性红斑狼疮 评估 

分 类 号：R593.241[医药卫生—内科学]