三种不同方法检测抗双链DNA抗体的比较分析  

Comparative analysis of three different methods to detect anti-double-stranded DNA antibodies

作　　者：丁耀东[1] 范雪丽[2] 胡彦[2] 陈华[2] 谭立明[3] 陈娟娟[3] 

机构地区：[1]南昌大学公共卫生学院 [2]南昌大学第一临床医学院 [3]南昌大学第二附属医院检验科,江西南昌330006

出　　处：《实验与检验医学》2015年第6期697-700,共4页Experimental and Laboratory Medicine

基　　金：国家自然科学基金青年基金(81401964);江西省青年科学基金(20142BAB215058);江西省教育厅青年基金(GJJ14185);南昌大学创新学分项目(14001849)

摘　　要：目的比较三种不同方法检测抗双链DNA(ds DNA)抗体的敏感度、特异度和符合度,并探讨其与系统性红斑狼疮(SLE)活动情况的一致性,以指导临床工作。方法采用回顾性分析方法 ,对640例住院患者及健康体检者血清标本进行研究,其中215例SLE患者,用间接免疫荧光法(IIF)、线性印迹法(LIA)、放射免疫分析法(RIA)同时检测抗ds DNA抗体。结果抗ds DNA抗体用IIF、LIA和RIA法在SLE中的检出率分别为40.00%、43.72%、47.44%,与对照组有显著差异,三种方法特异性分别为98.35%、96.24%、94.59%,符合率分别为78.75%、78.59%、78.75%,具有极好的一致性(Kappa>0.8);三种方法在SLE活动期的检出率分别为60.76%、58.23%、60.76%,与SLE稳定期有显著差异,用RIA检测的抗ds DNA抗体的浓度与SLE活动性存在显著的线性趋势(P<0.05)。结论抗ds DNA抗体不仅可以作为SLE患者的诊断标准还对其活动性的评估有着指导作用;三种方法学有着各自的优缺点,有条件的医院建议联合采用两种以上方法相互印证。Objective To analyze the sensitivity,specificity and coincidence rate of three methods for detecting anti-double stranded DNA（anti-ds DNA） antibody,and to explore the correlation of anti-ds DNA results and activity of systemic lupus erythematosus（SLE）. Methods Anti-ds DNA antibody from 640 cases of inpatient and healthy controls,including 215 cases of SLE were measured by indirect immunofluorescence（IIF）,linear imprinting assay（LIA） and radioimmunoassay（RIA）. Then the data were analyzed using retrospective method. Results The detectable rates of anti-ds DNA antibody in SLE by IIF,LIA and RIA were 40.00%,43.72%and 47.44% respectively,with significant differences against the control group. The specificity of the three methods were 98.35%,96.24% and 94.59% respectively,in which the coincidence rates were 78.75%,78.59% and 78.75% respectively（kappa0.8）. Of all the active SLE case diagnosed by the methods of IIF,LIA and RIA the detectable rates were 60.76%,58.23%and 60.76% respectively,which significantly differentiate stable SLE from active SLE. Moreover,the concentration of anti-ds DNA antibody by RIA and the activity of SLE were found to exist in an outstanding linear trend（P〈0.05）. Conclusion Anti-ds DNA antibody played an important role in the diagnosis and active evaluation of SLE,which suggested the combination usage of two or more methods if possible.

关 键 词：系统性红斑狼疮 双链DNA抗体 间接免疫荧光法 线性印迹法 放射免疫法 

分 类 号：R446.62[医药卫生—诊断学]