联合检测AnuA和抗dsDNA抗体对系统性红斑狼疮的诊断价值  

Significance of combined detection of AnuA and anti-dsDNA antibody in systemic lupus erythematosus

作　　者：徐腾飞[1] 吴海鸥[1] 

机构地区：[1]威海市立医院,威海市264200

出　　处：《实用检验医师杂志》2016年第3期165-167,共3页Chinese Journal of Clinical Pathologist

摘　　要：目的探讨联合检测血清中抗核小体抗体(AnuA)和抗双链DNA(dsDNA)抗体对系统性红斑狼疮(SLE)诊断及病情评估的价值。方法选择2013年8月至2015年9月威海市立医院收治的85例SLE患者为SLE组,同期60例其他风湿性疾病或自身免疫病患者作为对照组。对两组患者血清AnuA和抗dsDNA抗体及抗Sm、SSA、SSB抗体检测结果进行比较分析,观察AnuA和抗dsDNA抗体诊断SLE的敏感度和特异度。结果 SLE组AnuA和抗dsDNA抗体阳性率均明显高于对照组[AnuA:55.3%(47/85)比6.7%(4/60),抗dsDNA抗体:45.9%(39/85)比6.7%(4/60),P均<0.01],两者联合检测的阳性率为49.4%(42/85);SLE组抗Sm抗体阳性率明显高于对照组[17.6%(15/85)比3.3%(2/60),P<0.01],但SLE组和对照组抗SSA抗体阳性率[68.2%(58/85)比61.7%(37/60)]和抗SSB抗体阳性率[21.2%(18/85)比31.7%(19/60)]比较差异无统计学意义(P均>0.05)。AnuA和抗dsDNA抗体诊断SLE的特异度较高,均为93.3%,但敏感度较低(分别为45.8%和55.3%);而二者联合检测的敏感度为59.3%,特异度为86.7%。在AnuA和(或)抗dsDNA抗体阳性的SLE患者中,血常规及肾功能等实验室指标较2种抗体均阴性患者升高2倍以上(P均<0.05)。结论 AnuA和抗dsDNA抗体联合检测对SLE诊断效率高于单独检测两种抗体,且对SLE疾病活动性有评估价值。Objective To explore the diagnostic significance and disease assessment of combined detection of antinucleosome antibody （AnuA） and anti-dsDNA antibody in serum in systemic lupus erythematosus （SLE）. Methods Eighty-five patients with SLE admitted to Weihai City Hospital from August 2013 to September 2015 were enrolled, and 60 patients with other rheumatic diseases or autoimmune diseases were served as control group. The serum levels of AnuA and anti-dsDNA antibody were recorded. The results of anti-Sm, anti-SSA and anti-SSB antibodies were compared. The sensitivity and specificity of SLE diagnosis for AnuA and anti-dsDNA antibody were analyzed. Results Compared with control group, positive rates of AnuA and anti- dsDNA antibody in SLE group were significantly increased [AnuA： 55.3% （47/85） vs. 6.7% （4/60）, anti-dsDNA antibody： 45.9% （39/85） vs. 6.7% （4/60）, P all 〈 0.01]. The positive rate of combined detection was 49.4% （42/85） in SLE group. The positive rate of anti-Sm antibody in SLE group was significanty higher than that of control group [17.6% （15/85） vs. 3.3% （2/60）, P 〈 0.01], but there was no significant difference in the positive rates of anti-SSA antibody [68,2% （58/85） vs. 61.7% （37/60）] and anti-SSB antibody [21.2% （18/85） vs. 61.7% （37/60）] between SLE group and eontrol group （P all 〉 0.05）. The specificity of AnuA and anti-dsDNA antibody in the diagnosis of SLE was higher, both 93.9%, but the sensitivity was lower （45.8% and 55.3% respectively）. The sensitivity of combination of AnuA and anti-dsDNA was 59.3%, and the specificity was 86.7%. In patients with SLE whose AnuA or anti-dsDNA antibody was positive, routine blood, kidney function and serum complement tests were obviously different from negative patients （P all 〈 0.05）. Conclusion Combined detection of AnuA and anti-dsDNA antibody could improve the diagnosis efficiency of SLE as compared with AnuA or anti-dsDNA alone, and have application values in disease activities

关 键 词：系统性红斑狼疮 抗核小体抗体 抗双链DNA抗体 

分 类 号：R446.6[医药卫生—诊断学] R593.241[医药卫生—临床医学]