系统性红斑狼疮患者血清中F-肌动蛋白抗体检测的临床应用  

Detection of F-actin autoantibodies in the serum of patients with systemic lupus erythematosus

作　　者：吴兆立 刘湘 杨惠琴[2] 宁勇 赵岚[1] 黄伟[1] 程贵莲 熊银[1] 李妹[1] 全紫瑶 崔天盆[1] Wu Zhaoli;Liu Xiang;Yang Huiqin;Ning Yong;Zhao Lan;Huang Wei;Cheng Guilian;Xiong Yin;Li Mei;Quan Ziyao;Cui Tianpen(Laboratory of Clinical Immunology,Wuhan No.1 Hospital,Hubei 430022,China)

机构地区：[1]武汉市第一医院检验科,430022 [2]武汉市第一医院风湿免疫科,430022 [3]湖北中医药大学检验学院

出　　处：《中华风湿病学杂志》2018年第8期543-547,共5页Chinese Journal of Rheumatology

基　　金：国家自然科学基金面上项目（81770038）;武汉市临床医学科研项目重点项目（WX17-A01）

摘　　要：目的探讨SLE患者血清中F-肌动蛋白抗体检测的临床价值及其与其他临床指标的相关性。方法ELISA法检测2017年3月至2018年1月武汉市第一医院收治的93例SLE患者（病例组），72例RA患者（疾病对照组）和同期83名体检健康者（健康对照组）血清中F-肌动蛋白抗体水平，并分析3组结果的阳性率；回顾性分析病例组93例患者的SLEDAI、血清免疫球蛋白G（IgG）、ESR、抗dsDNA抗体及ANA临床指标数据，将F-肌动蛋白抗体单位数值与上述各指标逐一进行相关性分析；利用受试者工作特征曲线（ROC）分析F-肌动蛋白抗体单位数值对SLE的诊断价值。采用t检验，χ2检验和Spearman／Pearson相关分析进行统计分析。结果SLE病例组、疾病对照组和健康对照组血清中F-肌动蛋白抗体平均水平分别为（18±13）U、（12±6）U和（11±5）U，SLE病例组与疾病对照组、健康对照组差异均有统计学意义（t=3．163，P=0．0019;t=4．436，P〈0．01）；SLE病例组血清中F-肌动蛋白抗体阳性率为33％（31／93），与疾病对照组（10％，7／72）和健康对照组（4％，3／83）相比，差异均有统计学意义坼=12．76，P〈0．01；2z=24．84，P〈0．01）；SIN病例组F．肌动蛋白抗体单位数值与患者SLEDAI、IgG、ESR、抗dsDNA抗体及ANA均呈正相关（r=0．2737，P=0．0083；r=0．5587，P〈0．01；r=0．4199，P=0．0001；r=0．3514，P=0．0011；r=0．4609，P〈0．01），其中，F-肌动蛋白抗体单位数值与IgG及ANA相关性最明显；ROC曲线中，曲线下面积（AUC）为0．62[95％CI（0．54，0．70）]，差异有统计学意义（P=0．0013）。F-肌动蛋白抗体单位数值的临界值（cut-off值）为14．04U时，约登指数最大（YI=0．30），对SLE的诊断敏感度为0．77，特异度为0．53。结论F-肌动蛋白抗体在SLE患者血清中的平均水平和阳性率较RA患者和健康人群高，对SLE有一定的诊断价值；F-�Objective To investigate the value of F-actin autoantibodies in the serum of patients with systemic lupus erythematosus （SLE）, and to explore the relationships between F-actin autoantibodies and other clinical indicators. Methods ELISA was established to detect serum levels of F-actin autoantibodies in 93 inpatients with SLE from March 2017 to January 2018 （case group, n=93）, 72 patients with rheumatoid arthritis （RA） （disease control group） and 83 healthy subjects （healthy control group） were included during the same period. The positive rates of F-actin autoantibodies between the case group and the two control group were compared. Clinical data including SLE disease activity index （SLEDAI）, immuno-globulin （Ig）G, erythrocyte sedimentation rate （ESR）, anti-dsDNA, and antinuciear antibody （ANA） of 93 patients with SLE were collected and the correlation analysis between F-actin autoantibodies units was applied respectively. The diagnostic performance of F-actin autoantibodies in SLE was analyzed by using the receiver operating characteristic curve （ROC）. T test, Chi-square test and Spearman/Pearson correlation analysis were applied for statistical analysis. Results The serum levels of F-actin autoantibodies in the SLE case group, disease control group, and healthy control group were （18±13）, （12±6）, and （11±5） U, respectively, the differences between SLE case group and disease control group, and healthy control group were significant （t=3.163, P=0.001 9; t=4.436, P〈0.01）. The positive rates of F-actin autoantibodies were 33%（31/93） in patients with SLE, 10%（7/72） in disease control group, and 4%（3/83） in healthy control group. The F-actin autoanti-bodies units in SLE were correlated with SLEDAI, IgG, ESR, anti-dsDNA, and ANA （r=0.273 7, P=-0.008 3; r=0.558 7, P〈O.O1; r=0.419 9, P=0.000 1, r= 0.351 4, P=0.001 1, r=0.460 9, P〈0.01）, in which F-actin autoantibodies units showed significant correlation with lgG and ANA. In the ROC curve,

关 键 词：肌动蛋白类 红斑狼疮 系统性 生物学标记 

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