2015年某医院402例系统性红斑狼疮患者多种自身抗体检测结果分析  

Analysis of autoantibodies in 402 patients with systemic lupus erythematosus hospitalized in 2015

作　　者：胡同平[1] 张文兰[1] 白力[1] 鲁芙爱[1] 耿丽霞[1] 常志芳[1] 尹芳蕊[1] 王馨[1] 安燕[1] 魏斐菲 

机构地区：[1]包头医学院风湿免疫研究所,014010

出　　处：《中国药物与临床》2017年第2期157-159,共3页Chinese Remedies & Clinics

基　　金：国家自然科学基金(81360464)

摘　　要：目的通过对我院2015年402例系统性红斑狼疮(SLE)患者血清中抗核抗体(ANA)、抗核小体抗体(Anu A)、抗Sm抗体(Sm)、抗ds DNA抗体(ds DNA)、抗组蛋白抗体(AHA)及抗核糖体P蛋白抗体(ARP)检测结果的分析,并与其他疾病对照组和健康对照组相比较,探讨它们在SLE中的诊断价值。方法采用间接免疫荧光法检测ANA;免疫印迹法检测Anu A、抗Sm抗体、抗ds DNA抗体、AHA和ARP。检测402例SLE患者和126例其他疾病对照组及80名健康体检者。结果在检测的402例SLE患者中,ANA、Anu A、抗Sm抗体、抗ds DNA抗体、AHA、ARP的阳性率分别为95.8%、72.4%、55.5%、76.6%,29.1%、14.2%。在126例其他疾病对照组中,ANA、Anu A、抗Sm抗体、抗ds DNA抗体、AHA、ARP的阳性率分别为41.3%、1.6%、10.3%、8.7%,17.5%、0.8%。而在80名健康体检者中,仅2例ANA阳性,阳性率为2.5%,其余均为阴性。ANA、Anu A、抗Sm抗体、抗ds DNA抗体、AHA、ARP对诊断SLE的特异度分别为73.8%,99.0%,93.7%,94.7%,89.3%,99.5%。在Anu A、抗Sm抗体、抗ds DNA抗体三者中,任何一项检测结果阴性时,其他2种自身抗体均出现一定阳性率,并以Anu A在抗ds DNA抗体、抗Sm抗体阴性时阳性检出率最高,达69.5%和72.4%。三者联合检测,任一阳性,对诊断SLE的敏感度可达88.2%。三者均阳性,对诊断SLE的特异度可达100%。结论 ANA对SLE诊断的敏感度最高,但其特异度最低;Anu A、抗Sm抗体、抗ds DNA抗体、AHA、ARP对SLE的诊断均具有较高的特异性,可作为SLE诊断的可靠指标。多种自身抗体联合检测在SLE诊断中具有互补性,对SLE的诊断和鉴别诊断具有重要的临床意义。Objective To determine the antinuclear antibody（ANA）, anti-nucleosome antibody（Anu A）, anti-Sm antibody, anti-ds DNA antibody, anti-histone antibody（AHA） and anti-ribosomal P protein antibody（ARP） in the serum of 402 patients with systemic lupus erythematosus（SLE）, who were hospitalized in our hospital in 2015, and to com-pare them with those in the control group of other diseases and healthy control group to investigate their diagnostic values in SLE. Methods ANA was determined by indirect immunofluorescence assay; Anu A, anti Sm antibody, anti ds DNA body, AHA and ARP were determined by immunoblotting. A total of 402 SLE patients, 126 patients in the control group of other diseases and 80 healthy subjects were examined. Results The positive rates of ANA, Anu A,anti Sm antibody, anti ds DNA body, AHA and ARP were 95.8%, 72.4%, 55.5%, 76.6%, 29.1% and 14.2% in 402 SLE patients, respectively. The positive rates of ANA, Anu A, anti Sm antibody, anti ds DNA body, AHA and ARP were 41.3%, 1.6%, 10.3%, 8.7%, 17.5% and 0.8% in 126 patients in the control group of other diseases, respectively.In 80 healthy subjects, there were only 2 cases of ANA-positive, with the positive rate of 2.5%, and the rest were negative. The specificity of ANA, Anu A, anti Sm antibody, anti ds DNA body, AHA and ARP were 73.8%, 99.0%,93.7%, 94.7%, 89.3% and 99.5% in diagnosing SLE, respectively. Among Anu A, anti Sm antibody and anti ds DNA body, when any one of the test result was negative, the other two autoantibodies showed certain positive rates. The positive rate of Anu A was the highest in anti ds DNA body and anti Sm dody-negative, which reached to 69.5% and72.4%, respectively. In the three autoantibodies joint test, when any one of the three antibodies was positive, the sen-sitivity for the diagnosis of SLE could reach to 88.2%. The specificity for the diagnosis of SLE could reach to 100%when all of the three antibodies were positive. Conclusion ANA is the most sensitive to SLE diagnosis, but its specificity is the l

关 键 词：红斑狼疮 系统性 抗体 抗核 自身抗体 

分 类 号：R593.241[医药卫生—内科学]