血清铁蛋白检测辅助诊断系统性红斑狼疮的应用价值探讨

目的：研究血清铁蛋白（FET）对系统性红斑狼疮（SLE）的诊断及监测意义.方法：收集本院2012年1月～2012年12月收治于风湿免疫科的146例确诊SLE的患者为观察组,随机收集本院同期其他疾病患者（感染性疾病、肿瘤、其他自身免疫性疾病）65例为对照组1,随机收集本院同期体检中心健康人105例为对照组2,分别检测各组血清铁蛋白、抗双链DNA抗体水平、C反应蛋白（CRP）、红细胞沉降率（ESR）,记录患者各项临床资料,并进行统计学分析.结果：SLE组患者血清FET水平显著高于对照组1及对照组2（均P＜0.01）.血清FET对SLE诊断价值的ROC曲线下面积为0.715 （95％置信区间0.634～0.795,以健康志愿者组及其他疾病组为参考人群）;单独测定FET在SLE患者中的阳性率（41.78％）不及检测dsDNA的阳性率高（83.56％）,联合dsDNA测定血清FET可提高SLE诊断的阳性率（92.47％）.SLE患者血清FET水平与CRP低度相关（r=0.351）,与ESR相关程度较弱（r=0.273）.结论：血清FET对SLE诊断有一定价值,通过与dsDNA、CRP、ESR等指标的联合检测对SLE诊断及病情监测起重要作用.

Estimation of serum ferritin levels for diagnosis of patients with systemic lupus erythematosus

Objective：To investigate the diagnostic value of serum ferritin in patients with systemic lupus erythematosus （SLE）.Methods：We collected 146 SLE patients.Among them,65 patients suffered from other diseases （infectious disease,cancer etc.）,were the 1st control group, 105 healthy volunteers as the second control group.Serum ferritin, C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）and anti-double-stranded DNA antibodies （dsDNA）were measured in these three groups by chemiluminescent measurement,immunoturbidimetric assay,Westergren＇s method and ELISA,respectively.The clinical data were recorded and analyzed. Results：The level of serum FET in patients with SLE patients was significantly higher than that of control groups （P〈0.01）.The area under the ROC curve of serum FET in the diagnosis of SLE was 0.715（95% confidence interval was 0.634-0.795）;the positive rate of FET alone in patients with SLE was less than the positive rate of dsDNA （41.78% and 83.56%,respectively）,the combined determination of serum FET and dsDNA improved the positive rate of SLE（92.47%）.The levels of serum ferritin in SLE patients were positively correlated with serum CRP （r=0.351,P〈0.01）and it was not related with ESR （r=0.273）.Conclusion：The level of serum FET has a certain diagnostic significance for SLE.With the combination of detecting dsDNA,CRP,ESR and other indicators,it plays an important role in SLE diagnosis and disease detection.