抗细胞膜DNA抗体在系统性红斑狼疮诊断中的应用价值  

Diagnostic value of anti-cell membrane DNA antibodies for systemic lupus erythematosus

作　　者：戚建锋[1] 吴翡斐[1] 施金俏[1] 翁巍[1] 王文琴[1] 王利民[2] 

机构地区：[1]金华市人民医院风湿免疫实验室,321000 [2]金华市中心医院检验科

出　　处：《浙江医学》2017年第21期1865-1867,1871,共4页Zhejiang Medical Journal

基　　金：金华市科技计划项目(2014-3-074)

摘　　要：目的探讨抗细胞膜DNA(mDNA)抗体在系统性红斑狼疮(SLE)诊断中的应用价值。方法选择SLE患者137例(SLE患者组),同期其他自身免疫性疾病患者72例(其他自免疾病组),同期健康体检者84例(健康对照组)。采用间接免疫荧光法检测抗mDNA抗体和抗核抗体(ANA),采用ELISA法检测抗双链DNA(ds-DNA)抗体,采用免疫印迹法检测核糖体P蛋白(Rib-P)抗体、抗史密斯(Sm)抗体及抗核小体抗体(AnuA)等其他自身抗体,评价各自身抗体指标在3组血清中的灵敏度和特异度,以寻找诊断SLE的最佳免疫学指标组合。结果抗mDNA抗体在SLE患者组中的灵敏度(62.8%)明显高于其他自免疾病组(12.5%)和健康对照组(2.4%),也明显高于抗ds-DNA抗体(40.9%)、Rib-P抗体(21.2%)、抗Sm抗体(18.2%)和AnuA(17.5%),差异均有统计学意义(P<0.05)。137例SLE患者血清中抗ds-DNA抗体、Rib-P抗体、抗Sm抗体、AnuA分别与抗mDNA抗体联合检测的灵敏度明显高于其自身单独检测的灵敏度,差异均有统计学意义(均P<0.01)。在抗ds-DNA抗体、Rib-P抗体、抗Sm抗体、AnuA4种抗体均阴性的SLE患者中,抗mDNA抗体的阳性率达65.9%,联合其他抗体能明显提高SLE的阳性率(87.6%)。结论抗mDNA抗体是一种灵敏度较高、特异度强的SLE血清学标志之一,与其他抗体联合检测在SLE诊断中有良好的互补作用,可明显提高灵敏度,从而提高SLE的临床诊断。Objective To assess the diagnostic value of anti-cell membrane DNA（mDNA） antibodies for systemic lupus erythematosus（SLE）. Methods The serum samples from 137 SLE patients（SLE group）, 72 non-SLE autoimmune diseases patients（non-SLE group） and 84 healthy subjects（control group） were collected. The antinuclear antibody（ANA） and anti-mDNA antibody were detected by indirect immunofluorescence assay, anti-double-stranded DNA（dsDNA） was detected by ELISA,ribosomal P protein（Rib-P） antibody, anti-Smith（Sm） antibody and anti-nucleosome antibody（AnuA） were detected by immunoblotting（IBT）. The diagnostic values of above indicators were assessed. Results The positive rate of anti-mDNA antibody in SLE patients（62.8%） was significantly higher than that in non-SLE groups（12.5%） and control group（2.4%）, which was significantly higher than that of anti-ds-DNA antibodies（40.9%）, Rib-P antibody（21.2%）, anti-Sm antibody（18.2%） and AnuA（17.5%）（all P〈0.05）. The sensitivity of combination of anti-mDNA antibody with anti-ds-DNA antibody, Rib-P antibody, anti-Sm antibody or AnuA for diagnosis of SLE was all significantly higher than that of anti-mDNA alone（all P〈0.01）. The positive rate of anti-mDNA antibody was 65.9% in SLE patients with other antibodies negative. The combination of anti-mDNA antibody with other antibodies significantly improved the detection rate of SLE（87.6%）. Conclusion Anti-mDNA antibody is a sensitive serological marker of SLE, combination of anti-mDNA antibody with other indicators may further improve the sensitivity in diagnosis of SLE.

关 键 词：抗细胞膜DNA抗体 系统性红斑狼疮 灵敏度 特异度 

分 类 号：R593.241[医药卫生—内科学]