联合检测ANuA、Anti-ds-DNA、anti-P和Anti-sm在SLE伴肾损害患者中的诊断价值  

Diagnostic value of combined detection of AnuA,anti-ds-DNA,anti-P and anti-sm in SLE patients with renal impairment

作　　者：王立鼎[1] 唐晓磊 秦嫚 WANG Liding;TANG Xiaolei;QIN Man(Laboratory of Hematology,Huangshan People's Hospital,Huangshan,Anhui,China,245000;Medical Translational Center,the Second Affiliated Hospital of Wannan Medical College,Wuhu,Anhui,China,241000;Department of Clinical Laboratory,Anhui Second People's Hospital,Hefei,Anhui,China,230000)

机构地区：[1]黄山市人民医院血液病实验室,安徽黄山245000 [2]皖南医学院第二附属医院医学转化中心,安徽芜湖241000 [3]安徽省第二人民医院检验科,安徽合肥230000

出　　处：《分子诊断与治疗杂志》2023年第1期165-168,共4页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省卫健委自然科学重点项目(AHWJ2021a015)。

摘　　要：目的 探究抗核小体(ANuA)、抗双链DNA(Anti-ds-DNA)、抗核糖体P蛋白(anti-P)和抗Sm抗体(Anti-sm)联合检测在系统性红斑狼疮(SLE)伴肾损害患者中的诊断价值。方法 选取2019年1月至2022年4月黄山市人民医院收治的SLE患者163例为研究对象,根据患者是否合并肾损害分为SLE组(n=55)与SLE伴肾损害组(n=108)。收集两组患者血清进行ANuA、Anti-ds-DNA、anti-P和Anti-sm检测,比较两组上述抗体单一及联合检测的阳性率,并绘制ROC曲线分析上述抗体指标对SLE伴肾损害的诊断价值。结果 SLE组Anti-ds-DNA、Anti-sm抗体单一及联合检测阳性率均高于SLE伴肾损害组,差异均具有统计学意义(χ^(2)=18.360、10.513、8.010,P<0.05);SLE组ANuA、anti-P检测阳性率均低于SLE伴肾损害组,差异均具有统计学意义(χ^(2)=7.094、4.281,P<0.05)。多因素Logistic回归分析显示,ANuA(β=2.284,OR=9.816)、Anti-ds-DNA(β=0.749,OR=2.115)、anti-P(β=1.386,OR=3.999)和Anti-sm(β=0.475,OR=1.608)是SLE伴肾损害的独立影响因素(P<0.05)。ROC曲线显示,ANuA、Anti-ds-DNA、anti-P和Anti-sm四者联合检测时,预测SLE伴肾损害的AUC为0.911,敏感性、特异性分别为89.0%、92.6%,优于单一检测(P<0.05)。结论 ANuA、Anti-ds-DNA、anti-P和Anti-sm都与SLE伴肾损害有关,联合检测ANuA、Anti-ds-DNA、anti-P和Anti-sm对于提高SLE伴肾损害的诊断准确性具有重要价值。Objective To investigate the combined detection of anti-nucleosome antibody(ANuA),anti-doublestrain DNAantibody(anti-ds-DNA),anti-ribonucleoproteinantibody(anti-P)and anti-Smith antibody(anti-sm)in systemic erythema. To evaluate the expression and diagnostic value of systemic lupus erythematosus(SLE)patients with renal impairment. Methods A total of 163 SLE patients who were admitted to Huangshan People’s Hospital from January 2019 to April 2022 were selected as the research objects,and they were divided into the SLE group(n=55)and the SLE with renal impairment group(n=108)according to whether the patients were complicated with renal damage. The sera of the two groups of patients were collected for AnuA,anti-ds-DNA,anti-P and anti-sm detection,the positive rates of single and combined detection of the above antibodies in the two groups were compared,and the ROC curve was drawn to analyze the effect of the above antibody indicators on SLE with renal damage. Results The positive rates of single and combined anti-ds-DNA and anti-sm antibodies in the SLE group were higher than those in the SLE group with renal damage,and the differences were statistically significant(χ^(2)=18.360,10.513,8.010,P<0.05). The positive rates of ANuA and anti-P in the SLE group were lower than those in the SLE group with renal damage,and the differences were statistically significant (χ^(2)=7.094,4.281,P<0.05). Multivariate Logistic regression analysis showed that ANuA(β=2.284,OR=9.816)、anti-ds-DNA(β=0.749,OR=2.115)、anti-P(β=1.386,OR=3.999)and anti-sm(β=0.475,OR=1.608)was an independent influencing factor of SLE with renal damage(P<0.05). The ROC curve showed that when anti-nucleosome,anti-double-stranded DNA,antihistone and anti-sm antibodies were detected in combination,the AUC for predicting SLE with renal damage was 0.911,and the sensitivity and specificity were 89.0% and 92.6%,which better than single detection(P<0.05). Conclusion ANuA,anti-ds-DNA,anti-P and anti-sm are all related to SLE with renal damage.Combined detecti

关 键 词：抗核小体抗体 抗双链DNA 抗核糖体P蛋白抗体 抗SM抗体 系统性红斑狼疮 肾损害 

分 类 号：R593.241[医药卫生—内科学] R692[医药卫生—临床医学]