抗双链DNA抗体水平和抗体亲和力与SLE患者疾病状态的关系以及对两种方法检测能力的影响  

The correlation between the avidity or level of serum anti-dsDNA antibody with SLE disease progression and their influence on the performance of different detection techniques

作　　者：田野[1] 张云聪[2] 冯珍如[2] 闫惠平[3] 张岩[1] 张海萍[3] 李佩[1] 郑芳芳[1] 聂秋燕 刘晴[1] 王晓宁[1] 张国军[4] 谭延国[1] 

机构地区：[1]首都医科大学附属复兴医院检验科,100038 [2]北京大学第一医院检验科,北京100034 [3]首都医科大学附属北京佑安医院临床检验中心,100069 [4]首都医科大学附属北京天坛医院实验诊断中心,100050

出　　处：《检验医学与临床》2018年第2期151-153,156,共4页Laboratory Medicine and Clinic

基　　金：国家卫生和计划生育委员会医药卫生科技发展研究中心专项课题资助(28-5-5);首都临床特色应用研究(吴阶平)基金资助项目(Z141107006614008)

摘　　要：目的探讨抗双链DNA(dsDNA)抗体水平和抗体亲和力与系统性红斑狼疮(SLE)疾病活动性的关系,分析两种抗dsDNA抗体检测方法检出能力差异的原因。方法使用酶联免疫吸附试验(ELISA)和间接免疫荧光法(IIF)同时测定300例SLE患者(SLE组)和495例非SLE自身免疫疾病患者(非SLE疾病组),以及300例健康人(健康对照组)血清中的抗dsDNA抗体,然后进一步测定ELISA检测为阳性标本的抗dsDNA抗体亲和力指数。结果 (1)SLE组抗dsDNA抗体水平[285.8(164.5~463.3)IU/mL]明显高于非SLE疾病组[172.9(135.3~200.1)IU/mL],差异有统计学意义(P=0.038);SLE组抗体亲和力指数[32.3(19.2~50.7)]与非SLE疾病组[15.5(9.5~49.8)]差异无统计学意义(P=0.169);SLE组抗dsDNA抗体水平和抗体亲和力指数分别与SLEDAI评分呈显著正相关(P=0.000、0.002)。(2)ELISA和IIF同时检测为阳性的标本,其抗dsDNA抗体水平和亲和力指数均明显高于单独ELISA检测为阳性标本的抗体水平和抗体亲和力指数,差异有统计学意义(P<0.05)。结论抗dsDNA抗体水平及抗体亲和力指数与SLE疾病活动性密切相关,表明较高的抗体水平和抗体亲和力可能影响疾病进程,可作为病程监测的指标。IIF相对于ELISA,更倾向于检测出相对较高亲和力的抗dsDNA抗体。Objective To investigate the connection between the avidity or level of anti-dsDNA antibodywith the progression of systemic lupus erythematosus （SLE）,and their influence on the performance of two widely used techniques （ELISA and IIF）. Methods Using commercially available kits based on ELISA and IIF techniques simultaneously,serum anti-dsDNA antibody was determined from 300 patients with SLE,495 patients with non-SLE autoimmune disease,and 300 health controls （HCs）. Positive samples by ELISA were further determined for anti-dsDNA antibody avidity index using urea based ELISA kits. Results （1）the level and avidity index of anti-dsDNA antibody were significantly and insignificantly higher in SLE than non-SLE patients[antibody level..285.8（164.5-463.3） IU/mL vs. 172.9（135.3--200.1） IU/mL ,P=0. 038;antibody avidity index：32.3（19.2--50.7）vs. 15.5（9.5--49.8）,P=O. 169],and significantly correlated with SLEDAI scores, respectively （P = 0. 000,0. 002）. （2）For samples whose anti-dsDNA antibody were positive by both ELISA and IIF,their anti-dsDNA antibody levels and avidity indices were significantly higher than those sole- ly positive by ELSIA（P〈0.05）o Conclusion The closely correlation of anti-dsDNA level and avidity index with SLE disease progression,signifies that antibody amount and avidity might have been involved in disease development, and could also be used to monitor disease progression. For the determination of anti-dsDNA anti- body,IIF was more likely to detect antibodies of relatively higher avidity,in comparison with ELISA.

关 键 词：抗双链DNA抗体 抗体亲和力 间接免疫荧光法 系统性红斑狼疮 

分 类 号：R446.1[医药卫生—诊断学]