抗dsDNA抗体阴性的系统性红斑狼疮患者抗Sm抗体、抗Rib⁃P抗体水平及临床意义  

Levels and Clinical Significance of Anti-Sm Antibody and Anti-Rib-P Antibody in Patients with Anti-dsDNA-Antibody-Negative Systemic Lupus Erythematosus

作　　者：向会耀 王海燕[1] 马金阳[2] XIANG Huiyao;WANG Haiyan;MA Jinyang(Department of Laboratory,Yichang Central People's Hospital,the First Clinical College of Three Gorges University,Yichang,Hubei 443003,China;Department of Neurology,the First Clinical College of Three Gorges University,Yichang,Hubei 443003,China)

机构地区：[1]三峡大学第一临床学院,宜昌市中心人民医院检验科,湖北宜昌443003 [2]三峡大学第一临床医学院神经内科,湖北宜昌443003

出　　处：《临床误诊误治》2023年第5期98-101,共4页Clinical Misdiagnosis & Mistherapy

基　　金：湖北省自然科学基金计划项目(ZRMS20221431)。

摘　　要：目的探讨抗Sm抗体、抗Rib-P抗体对抗双链DNA(dsDNA)抗体阴性的系统性红斑狼疮的诊断价值。方法选择2020年8月—2021年8月收治的抗dsDNA抗体阴性的系统性红斑狼疮68例作为研究组,同期72例非系统性红斑狼疮的自身免疫性疾病患者作为对照组,同期体检健康者78例作为健康组。采用化学发光法检测3组抗Sm抗体、抗Rib-P抗体,随后采用受试者工作特征(ROC)曲线分析抗Sm抗体、抗Rib-P抗体对抗dsDNA抗体阴性的系统性红斑狼疮的诊断价值,以及研究组抗Sm抗体、抗Rib-P抗体与临床表现、实验室指标的关系。结果研究组抗Sm抗体、抗Rib-P抗体阳性率均高于对照组、健康组(P<0.05)。ROC曲线分析结果显示,抗Sm抗体联合抗Rib-P抗体诊断抗dsDNA抗体阴性的系统性红斑狼疮的曲线下面积及敏感度均高于单一指标诊断。研究组抗Sm抗体、抗Rib-P抗体阳性者蛋白尿发生率及C3阳性率明显高于抗Sm抗体、抗Rib-P抗体阴性者(P<0.05)。结论抗Sm抗体、抗Rib-P抗体对抗dsDNA抗体阴性的系统性红斑狼疮具有一定的诊断价值,且二者联合诊断价值更佳,有望作为诊断抗dsDNA抗体阴性的系统性红斑狼疮的有效指标。Objective To investigate the diagnostic value of anti-Sm antibody and anti-Rib-P antibody in patients with double-stranded DNA(dsDNA)-antibody-negative systemic lupus erythematosus(SLE).Methods Sixty-eight patients with dsDNA-antibody-negative SLE admitted from August 2020 to August 2021 were selected as the research group,72 patients with autoimmune diseases excluding SLE during the same period were selected as the control group,and 78 healthy subjects were selected as the healthy group.Anti-Sm antibodies and anti-Rib-P antibodies of the three groups were detected by chemiluminescence method,and then the diagnostic value of anti-Sm antibodies and anti-Rib-P antibodies in dsDNA-antibody-negative SLE was analyzed by receiver operating characteristic(ROC)curve.The relationship of anti-Sm antibodies and anti-Rib-P antibodies with clinical manifestations and laboratory indexes was analyzed.Results The positive rates of anti-Sm antibody and anti-Rib-P antibody in the research group were higher than those in the control group and healthy group(P<0.05).ROC curve analysis results showed that the area under the ROC curve(AUC)and sensitivity of anti-Sm antibody combined with anti-Rib-P antibody in the diagnosis of anti-dsDNA-antibody negative SLE were higher than that of single index.In the research group,the incidence of albuminuria and the positive rate of C3 in positive anti-Sm antibody and anti-Rib-P antibody were significantly higher than those in negative anti-Sm antibody and anti-Rib-P antibody(P<0.05).Conclusion Anti-Sm antibody and anti-Rib-P antibody have certain diagnostic value against dsDNA-antibody-negative SLE,and their combined efficacy is better.Therefore,they are expected to be effective indicators for the diagnosis of dsDNA-antibody-negative SLE.

关 键 词：红斑狼疮 系统性 抗双链DNA 自身免疫性疾病 抗SM抗体 抗Rib-P抗体 受试者工作特征曲线 曲线下面积 诊断价值 

分 类 号：R593.241[医药卫生—内科学]