三种抗双链DNA抗体检测方法在系统性红斑狼疮诊断中的效能评价  

Evaluation on three anti-double-stranded DNA antibody detection methods in the diagnosis of systemic lupus erythematosus

作　　者：毕胜[1] 朱红艳[1] 余亚玲 沈燕迪 李文润[1] BI Sheng;ZHU Hong-yan;YU Ya-ling;SHEN Yan-di;LI Wen-run(Department of Clinical Laboratory,the First People’s Hospital of Yunnan Province/Affiliated Hospital of Kunming University of Science and Technology,Kunming Yunnan 650032,China;Department of Nephrology,the First People’s Hospital of Yunnan Province/Affiliated Hospital of Kunming University of Science and Technology,Kunming Yunnan 650032,China)

机构地区：[1]云南省第一人民医院/昆明理工大学附属医院检验科,云南昆明650032 [2]云南省第一人民医院/昆明理工大学附属医院肾内科,云南昆明650032

出　　处：《云南医药》2022年第4期4-7,共4页Medicine and Pharmacy of Yunnan

基　　金：云南省科技厅计划项目:基础研究专项(202101AT070235),基础研究计划(202101AY070001-245)。

摘　　要：目的IIFA、LIA和ELISA检测抗ds DNA抗体的性能。方法选取在本院就诊的93例SLE患者、84例其他自身免疫性疾病患者和50例健康人作为对照组,采用上述3种方法检测血清中的抗ds DNA抗体。结果在SLE患者组中,抗ds DNA抗体检测阳性率最高的是ELISA法(60.2%),其次为LIA法(46.2%),最低的为IIFA法(38.7%),均显著高于对照组,差异有统计学意义(P<0.05)。特异度与阳性预测值最高的是IIFA法(99.3%、97.3%),灵敏度与阴性预测值最高的是ELISA法(60.2%、77.7%),ROC曲线下面积最大是ELISA(0.782),其次是LIA法(0.724),IIFA法(0.690)。IIFA法和LIA法(Kappa=0.881,P<0.001)、LIA方法和ELISA(Kappa=0.804,P<0.001)诊断结果一致性较好;IIFA方法和ELISA方法诊断结果一致性一般(Kappa=0.693,P<0.001)。结论推荐ELISA法联合IIFA法检测抗dsDNA抗体,对SLE诊断和病情活动监测有重要意义。Objective To evaluate the performance of IIFA,LIA and ELISA in detecting anti-ds DNA antibody.Methods 93patients with SLE,84 patients with other autoimmune disease and 50 healthy person in the hospital were selected.The serum antidouble stranded DNA antibody was detected simultaneously by the methods of IIFA,LIA and ELISA.Results The positive rate of anti-ds DNA antibody in SLE group by ELISA method was the highest,the second was by LIA method(46.2%),and the lowest was by IIFA method(38.7%),which were higher than that in the control group,there was statistical significance in the difference(P<0.05).The highest specificity and positive predictive value were IIFA(99.3%,97.3%),the highest sensitivity and negative predictive value were ELISA(60.2%,77.7%),the largest area under ROC curve was ELISA(0.782),followed by LIA(0.724)and IIFA(0.690).IIFA and LIA(Kappa=0.881,P<0.001),LIA and ELISA(Kappa=0.804,P<0.001)had good consistency,while IIFA and ELISA had general consistency(Kappa=0.693,P<0.001).Conclusion ELISA combined with IIFA is recommended to detect anti-ds DNA antibody,which contribute to the diagnosis and monitor disease activity of SLE.

关 键 词：抗双链DNA抗体 系统性红斑狼疮 间接免疫荧光法 免疫印迹法 酶联免疫吸附法 

分 类 号：R446.6[医药卫生—诊断学]