中性粒细胞胞浆抗体异常在诊断系统性红斑狼疮中的临床价值

目的探讨抗中性粒细胞胞浆抗体（antineutrophilcytoplasmicantibody，ANCA）异常对诊断系统性红斑狼疮（systemiclupuserythematosus，SLE）肾功能损害患者的临床意义。方法采用间接免疫荧光法（indirectimmuno—fluorescence，IIF）检测抗中性粒细胞胞浆抗体并对其结果进行回顾性分析。结果SI。E患者ANCA阳性率是35．2％，与混合性结缔组织病（mixedconnectivetissuedisease，MCTD）和其他自身免疫病患者相比，有统计学差异（P〈0.01）。SLE患者ANCA阳性组中，p-ANCA与c—ANCA阳性率有统计学差异（P〈0．01）。ANCA阳性组与阴性组比较，肾功能损害发生率明显升高（P〈0．05）。结论血清p-ANCA抗体检测对诊断SLE患者早期发现及防范肾毒性损害有重要意义。

Clinical Significance of Antineutrophil Cytoplasmic Antibody in Patients with Systemic Lupus Erythematosus

Objective To investigate the clinical significance of antineutrophil cytoplasmic antibody （ANCA） in the diagnosis of systemic lupus erythematosus （SLE）. Methods Indirect immunofluorescence （IIF） was used to detect relat- ed auto-antibodies ANA and ANCA in 256 SLE patients, 709 diseases control patients with mixed connective tissue dis- ease （MCTD） and 400 healthy individuals. Western blot was applied to explore their clinical significance in SLE diagno- sis. Enzyme-linked immunosorbent assay （ELISA） was employed to test myeloperoxidas （MPO）antibody. Results The positive rate of ANCA in SLE patients was 35.2~, which was significantly different compared with patients with disease control and healthy control groups （P~0. 01 ）. The positive rates p-ANCA and c-ANCA in SLE group with positive AN- CA were significant different （P〈0. 01 ）. The SLE subgroup with positive ANCA had higher level of kidney damage than the subgroup with negative ANCA （P〈0. 05）. Conclusion The detection of serum p-ANCA is important for early dis- covery, diagnosis and kidney damage prevention of SLE patients.