抗核小体抗体联合其他抗体检测对儿童与成人系统性红斑狼疮临床应用价值的对比研究  

Clinical use of anti-nucleosome antibody and other antibodies in diagnosis of systemic lupus erythematosus in children and adults: a comparative study

作　　者：颉晓香[1] 茹晋丽[2] 靳雪琴[2] 车国柱[2] 靳志勇[2] 高聪辉[2] 孙慧萍[2] 李小峰[3] 

机构地区：[1]山西医科大学,太原030001 [2]中国人民解放军第264医院风湿免疫科 [3]山西医科大学第二医院风湿免疫科

出　　处：《中国药物与临床》2016年第11期1549-1551,共3页Chinese Remedies & Clinics

基　　金：国家高技术研究发展计划(863计划)(012-AA02A513);国家十一五科技支撑计划(2008BAI59B02)

摘　　要：目的比较抗核小体抗体(AnuA)单独及与抗核抗体(ANA)、抗Sm抗体和抗双链DNA(dsDNA)抗体联合检测对儿童系统性红斑狼疮(JSLE)与成人SLE的诊断价值;探讨AnuA与JSLE和成人SLE的临床特点及SLE疾病活动指数(SLEDAI)评分的相关性并进行比校分析。方法选取141例JSLE及165例成人SLE患者,56例非JSLE及46例成人非SLE的疾病对照组,采用酶联免疫吸附法(ELISA)检测血清AnuA;收集JSLE和成人SLE患者同期临床资料及相关实验室检查结果,进行SLEDAI评分,分析JSLE和成人SLE患者AnuA与上述指标的相关性并进行比较分析。结果 JSLE与成人SLE发病性别组成差异无统计学意义。AnuA对JSLE的敏感度(74.47%)高于成人SLE组(59.39%),二者比较差异有统计学意义(P<0.05)。JSLE组AnuA与抗dsDNA抗体及抗Sm抗体联合检测敏感度分别为84.68%和83.47%,高于成人SLE组72.05%和65.99%,差异均有统计学意义。JSLE、成人SLE组AnuA与SLEDAI评分均呈正相关(r=0.239,P=0.032;r=0.125,P=0.014)。结论Aun A单独或与抗dsDNA抗体和抗Sm抗体联合检测,对JSLE诊断的敏感度均较成人SLE高。AunA与2组疾病活动度相关,为JSLE、成人SLE的诊断及疾病活动度的评估提供了又一临床应用价值。Objective To compare the diagnostic value of anti-nucleosome antibody （AnuA） alone and its com- bination with anti-nuclear antibody （ANA）, anti-Sm antibody and anti-double-stranded DNA antibody in children with juvenile systemic lupus erythematosus （JSLE） and adult with systemic lupus erythematosus （SLE）, and to investigate the correlation between AnuA and the clinical features of SLE in children and adults, and SLEDAI score. Methods A total of 141 patients with JSLE, and 165 patients with SLE were included in the study, 56 cases of non-JSLE and 46 cases of non-SLE disease were included as the control group. The serum AnuA was determined by enzyme-linked immunosorbent assay （ELISA）. The clinical data and related laboratory findings of JSLE and SLE patients from a con- temporary cohort were collected for SLEDAI scoring. The correlation between AnuA and the above-mentioned indexes in JSLE and SLE patients were analyzed and compared. Results There was no statistically significant difference in sex composition between JSLE and SLE. The sensitivity of AnuA to JSLE （74.47%） was higher than that of SLE （59.39%）, and there was significant difference between them （P〈0.05）. The sensitivity of combined determination of AnuA and anti-dsDNA antibody and anti-Sm antibody was 84.68% and 83.47% in the JSLE group, which was higher than 72.05% and 65.99% in the SLE group, respectively, and the difference was statistically significant. There was a positive correlation between AnuA and SLEDAI score in the JSLE and SLE groups （r=0.239, P=0.032; r=0.125, P= 0.014）. Conclusion Using AunA alone or its combination with anti-dsDNA antibody and anti-Sm antibody in the di- agnosis of JSLE has higher sensitivity than that of SLE. AunA correlates with the disease activity of the two groups, providing further clinical value for the diagnosis of SLE and the evaluation of disease activity in children and adults.

关 键 词：红斑狼疮 系统性 儿童 成人 抗核小体抗体 

分 类 号：R593.241[医药卫生—内科学]