免疫荧光技术在口腔扁平苔藓和慢性盘状红斑狼疮诊断中的价值

采用免疫荧光技术对口腔扁平苔藓（ＯＬＰ）和慢性盘状红斑狼疮（ＤＬＥ）的免疫病理学进行了研究，结果表明，ＩｇＧ和纤维蛋白原荧光抗体在上皮基底膜区沉积的阳性率两病之间有显著性差异；而胶样小体中出现的阳性率无显著性差异；两病患者的血清抗核抗体阳性率之间亦无显著性差异。     

神经精神性系统性红斑狼疮的磁共振表现

目的探讨神经精神性系统性红斑狼疮(NPSLE)的磁共振诊断价值。方法回顾性分析经临床证实的16例NPSLE的头颅磁共振表现。结果16例NPSLE患者的头颅MRI异常者13例,阳性率81.3%。其MRI表现为:(1)13例均为大脑半球受累,灰白质均可累及;(2)脑内多发片状异常信号8例(61.5%),分布无规律;(3)脑梗塞7例,脑水肿4例,出血2例;(4)脑萎缩2例;(5)5例增强扫描均无明显强化。结论结合临床资料,MRI可以诊断NPSLE。     

CT、MRI对系统性红斑狼疮脑病的诊断价值评价

目的 探讨CT和MRI在系统性红斑狼疮脑病(CNS—SLE)中的诊断价值。资料与方法回顾性分析17例经临床诊断符合系统性红斑狼疮诊断标准患者，男1例，女16例，年龄16～45岁。病史5～15年。17例均行常规CT扫描，14例行MR扫描，并结合临床资料进行分析。结果 CT扫描阳性率为94．1％(16／17)。其中9例表现为弥漫性基底节区的低密度灶，出血4例，脑萎缩8例，有5例表现为双侧豆状核钙化，1例为左侧尾状核头部钙化，仅1例未发现异常。MR扫描阳性率为100％(14／14)，10例表现为大脑、小脑、脑干及深部白质的长T1长T2异常信号，2例表现为小灶性出血，脑萎缩4例。结论 CT、MRI可对CNS-SLE的早期发现、鉴别诊断和疗效评价提供参考，但对于CNS-SLE的诊断，需结合临床资料。     

甘利欣辅助治疗皮肌炎、系统性红斑狼疮疗效观察

目的 对甘利欣辅助治疗皮肌炎、系统性红斑狼疮的临床疗效及安全性进行临床评价。方法 采用非盲法半随机对照法，试验组10例，对照组11例，均据病情需要使用激素，试验组辅以静滴甘利欣250～300mg/d，观察2～3周。结果 皮肌炎、系统性红斑狼疮对照组的总有效率为72.7%，试验组为80%；但两组间差异无统计学意义（P〉0.5）。皮损好转及生化酶学改变亦无统计学意义。不良反应轻微。结论 甘利欣辅助治疗皮肌炎、系统性红斑狼疮的临床疗效尚需进一步研究。     

Evaluation of the Crithidia assay to distinguish between auto-immune chronic active hepatitis and systemic lupus erythematosus

The aim of this study was to determine if the Crithidia luciliae assay for auto-antibodies to double-stranded DNA, often positive in systemic lupus erythematosus, is always negative in auto-immune chronic active hepatitis (CAH) as has recently been suggested. Twenty-five patients were identified as having auto-immune CAH. Mean duration of follow-up was 10.5 years. Antinuclear antibodies were detected in 92%, smooth muscle antibodies in 76% and antimitochondrial antibodies in 16%. Antibodies to double-stranded DNA were detected by the Crithidia assay in four patients (16%). Two of these patients had positive tests on only one occasion and no features of systemic lupus erythematosus. In the other two the assay was persistently positive. During follow-up both developed arthritis and serositis but the liver lesion remained the dominant clinical feature. It was concluded that there is significant serological overlap between auto-immune CAH and systemic lupus erythematosus making the Crithidia assay unreliable in distinguishing between them.     

一种用于基因表达谱分析的基因芯片方法

目的：通过研究SLE患者外周血基因表达谱的改变，建立一种新型的基因芯片技术用于分子发病机理的研究。方法：提取总RNA，逆转录合成单链cDNA、双链cDNA，体外转录合成生物标记的cRNA与基因芯片进行杂交，通过抗体的检测标记荧光染料Cy3，基因芯片扫描仪进行图像扫描。结果：该方法有较高的重复性和稳定性，SLE患者与正常对照组相比较，鉴定出94个基因存在表达差异。结论：该方法能在较少起始标本量的情况下，有效地进行SLE致病基因的筛选，更好的理解SLE发生的分子机理，并且可在其它疾病研究中推广应用。     

The Effects of Astragalus membranaceus and Tripterygium hypoglaucum on NK Activity in Systemic Lupus Erythematosus

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Immunoadsorbent apheresis eliminates pathogenic IgG in childhood lupus nephritis

BACKGROUND: It is suggested that the highly cation-charged fraction of the IgG and IgG3 subclasses may play a pathogenic role in lupus nephritis. In contrast, immunoadsorbent therapy using a sodium dextransulfate fixed cellulose gel column-low invasive selective immunoadsorbent apheresis therapy (SDSC-IAT) has been applied to lupus nephritis with favorable results. However, elimination using pathogenic IgG by SDSC-IAT has never been investigated. METHOD: Two patients with diffuse proliferative lupus nephritis were treated using SDSC-IAT concomitant with immunosuppressive therapy. The eluates from the SDSC, and the patients' serum obtained before and just after SDSC-IAT were subjected to an IgG charge analysis using isoelectric focusing and immunoblotting, and also to laser nephelometry assay, which is used for measuring IgG subclass concentration. Indirect immunofluorescence staining was performed to detect IgG subclass deposition in the glomerulus. RESULTS: Both of the patients had an immediate decrease in anti-double-strand DNA antibody and in the circulating immune complex with a following clinical improvement. Repeated biopsies demonstrated improvement of glomerular lesions with a marked reduction of IgG and C3 deposition. The IgG of the SDSC eluates consisted of highly cation charged (isoelectric points: 9-10) fractions. In addition, IgG3 was specifically removed from the patients' serum using an SDSC among the IgG subclasses. The subclass of deposited IgG in the glomeruli showed IgG3 predominance. CONCLUSION: SDSC-IAT specifically removed the highly cation charged fractions of IgG and IgG3 from the patients' serum and the elimination of these fractions may have resulted in clinical improvement.