间接血凝法和对流免疫电泳法测定抗ENA抗体

本文分析和比较了被动间接血凝法(PHA)和对流免疫电泳(CIE)检测抗可提取性抗原(ENA)抗体的结果.发现SLE患者中35,700(60/68)抗RNP抗体阳性,39.9(67/168)抗Sm抗体阳性.15例MCTD中抗RNP抗体均阳性10000 PHA法检测抗Sm抗体敏感,而CIE法检测抗RNP抗体敏感.在PHA法中56℃加热一小时处理ENA和RNase消化ENA结果相似.     

系统性硬皮病患者血清抗核抗体与临床表现的相关性研究

目的 探讨系统性硬皮病(SSc)患者血清自身抗体与临床之间的关系.方法 对1981-2009年确诊为系统性硬皮病的283例患者的临床资料进行分析.结果 283例患者中,女253例(89.4%),平均发病年龄(35.9±12.6)岁,就诊时平均病程(4.3±4.5)年.弥漫性皮肤型SSc共125例(44.2%).ANA阳性96.8%,抗Scl-70抗体阳性54.4%,ACA阳性6.4%,抗RNP阳性23.7%,抗Sm抗体阳性7.1%,抗SSA抗体阳性25.1%,抗SSB抗体阳性7.1%,抗Jo-1抗体5H性1.1%,未检出抗rRNP抗体.抗Scl-70抗体、ACA均阳性者仪1例.在IcSSe中ACA阳性率较dcSSc中高(P<0.05).结论 抗核抗体检测有助于对SSc患者进行诊断、分型、预后及处理.     

结缔组织病患者的血清抗ENA抗体检测

作者用对流免疫电泳法检测了127份分别来自CTD(93份),其它皮肤病(14份)及正常人(20份)血清中的抗ENA抗体,结果Sm抗体仅见于SLE者,且其出现与病情活动与否无关.4例MCTD者RNP均阳性,3例SCLE中2例Ro/La抗体阳性.ANA阴性的9例SLE中,6例Ro抗体阳性.故认为抗ENA抗体的检测对CTD的临床诊断,分型,判断预后和指导治疗均有重要意义.     

猪胸腺ENA中Sm与RNP抗原活性的研究

本文报道了从猪胸腺制备的ENA中Sm,RNP抗原活性的有关研究工作.通过CIE法与从兔胸腺丙酮粉提取的ENA比较,发现SLE等结缔组织病患者血清中抗Sm、抗RNP抗体的检出率,用猪胸腺ENA虽高于用兔胸腺ENA,但两者并无显著性差异.通过对流免疫参比电泳和琼脂糖双向免疫扩散试验证实所检出的抗体为抗Sm或抗RNP抗体.SDS-PAGE平板电泳分析,发现猪ENA和兔ENA的成份一致,其主要成分的分子量为24kd.各批猪ENA,抗原活性相对稳定.制备的猪ENA使用方便,不同温度条件下保存较长时间不失抗原活性.     

获得性大疱性表皮松解症先发于SLE

作者报道3例及其他作者报告的2例确诊为获得性大疱性表皮松解症(EBA)之后发生SLE的病例,并检查了另外15例无SLE临床表现的EBA患者的血清狼疮相关抗体.结果提示SLE和EBA之间有明显的关系.在观察和检查的20例确诊为EBA的病例中,9例有狼疮相关抗体,其中5例在EBA确诊后出现SLE的临床表现和自身免疫血清学特征(抗dsDNA抗体、循环抗U1RNP抗体和ANA的阳性率均为100%,抗Ro/SSA抗体为20%;抗Sm抗体为20%),1例在诊断为EBA时即有U1RNP抗体,5例在SLE发病时均出现这种抗体.5例伴有SLE的EBA病人最终均出现了抗     

结缔组织疾病

960177 149例系统性红斑狼疮患者核抗原多肽抗体谱的检测/李月文…//云南医药。-1995,-16(4).-291 应用免疫印迹技术(IBT)检测149例系统性红斑狼疮(SLE)患者和70例健康人的细胞核内可抽提核抗原(ENA)多肽抗体,结果ENA多肽抗体阳性97例(65.12％),其中以Sm为主,阳性率为33.56％,抗核糖体抗体阳性率为12.1％,70例健康人均为阴性。在Sm阳性的病例中,6例伴有u_1RNP抗体阳性,3例伴有SSA抗体阳性,1例伴有SSB阳性。阳性患者血清在38、16.5、15 KD多肽呈现阳性,抗SSA的检测有助     

免疫印迹法和对流免疫电泳法检测ENA抗体的评价和意义

目的 :　评价两种检测可提取性核抗原 (ENA)多肽抗体方法在临床诊断中的价值。方法 :　同时应用免疫印迹法 (IBT)和对流免疫电泳法 (CIE)检测 2 18例结缔组织病 (CTD)患者和 15 0例非结缔组织病对照血清ENA多肽抗体 ,比较两者的检测结果。结果 :　CTD中用IBT法测得抗ENA抗体阳性 14 8例占 6 7.9% ,用CIE法阳性 133例占 6 1.0 % ,两者之间无显著性差异 (P >0 .0 5 )。IBT阳性而CIE阴性为 18例 ,IBT阴性而CIE阳性者 4例。IBT可以同时检测 7种ENA抗体 ,而CIE只能检测 4种ENA抗体 ,但由于两种方法抗原制作过程中某些技术性因素会出现假阴性和假阳性。结论 :　IBT是一种敏感性和特异性高而广谱的ENA血清学诊断方法 ,但同时应用CIE法可以相互补充和验证 ,从而提高抗ENA抗体检测的阳性率。     

抗Ro(SSA)、抗La(SSB、Ha)抗体检测及其临床意义

本文报告用对流免疫电泳法检测了各种CTD病人,非CTD病人及正常人血清中的抗Ro/La抗体,并着重分析了抚体与SLE病人临床特征的关系.抗Ro/La抗体在Sjogren综合征中的阳性率为80±12.64%,其中抗Ro抗体为70±14.49%,抗La抗体为30±14.49%,在SLE中,抗Ro/La抗体的阳性率为42.52±3.38%,其中抗Ro抗休为39.25±3.34%,抗La抗体为9.81±2.03%,在其它CTD中阳性率均低于1000.非CTD和正常人血清中均未检测到抗Ro/La抗体.在SLE中,具有抗Ro/La抗体者,高丙球蛋白血症和RF阳性率较高.这些病人中,不同抗体组合与某些临床特征有相关性,抗Ro抗体多反映病情较重,抗La抗体多反映病情较轻.这种抗体的检测对于SLE的诊断、分型及预后估计等方面有重要意义.     

自身抗体检测在系统性红斑狼疮诊断中的临床分析

目的 评价抗双链DNA (dsDNA)抗体、抗Sm 抗体、抗核小体抗体(anti-nucleosome antibody,AnuA)联合检测对系统性红斑狼疮(SLE)诊断的意义.方法 测定68例SLE患者,60例其他结缔组织病患者及50例健康体检人群血清中的自身抗体,酶联免疫吸附试验(ELISA)测定抗dsDNA抗体、AnuA;以免疫印迹法测定抗Sm抗体.结果 抗dsDNA抗体、抗Sm抗体和AnuA在SLE患者中的阳性检出率明显高于疾病对照组和正常对照组;AnuA检测对SLE诊断的敏感性为69.1%,高于其他两种自身抗体,三者检测的特异性均在95%以上;AnuA与抗dsDNA抗体或AnuA与抗Sm抗体的二联检测及三者同时联合检测的敏感性分别为80.9%、82.4%、85.3%,显著高于单个检测的敏感性(P<0.05).结论 血清抗dsDNA抗体、抗Sm抗体和AnuA检测对SLE诊断的特异性较高、敏感性不高,而三项联合检测明显提高了诊断SLE的敏感性,对SLE患者的早期正确诊断有重要意义.     

系统性硬皮病抗U1RNP抗体的检测及其临床意义

系统性硬皮病（SSc）患者体内存在着多种自身抗体,如抗Scl-70、抗U1RNP、抗着丝点抗体和抗RNA聚合酶抗体。国内外对抗U1RNP抗体与SSc的相关性研究较少。笔者发现SSc患者抗U1RNP抗体阳性率较高,故对314例SSc患者作了抗可提取核抗原（ENA）抗体检测,并就抗U1RNP抗体阳性患者的临床表现作一分析．探讨该抗体在SSc中的临床意义。     

Systemic lupus erythematosus: a genetic epidemiology study of 695 patients from China

Our purpose was to explore potential genetic models for systemic lupus erythematosus (SLE) and analyze genetic epidemiologic characteristics of SLE in a Chinese population. Data for 695 patients with SLE were obtained by using a uniform questionnaire. Patients, clinical characteristics and their family history were analyzed using software. A complex segregation analysis was conducted to propose potential genetic models for SLE. The mean ± SD age of onset were 30.2 ± 10.5 years and mean time to progression to SLE was 32.5 ± 44.4 months. The most frequent initial manifestations were malar rash (61.3%). During the evolution of the disease, the main clinical features were arthritis in 73.6% of our patients, followed by malar rash (68.1%), and renal involvement (56.7%). As the first symptom, the late-onset group (onset of disease beyond the age of 50 years) less often showed malar rash (45% vs. 63.4% in the early-onset group; p = 0.001). There were no significant differences in the other cumulative clinical symptoms between late-onset and early-onset group, except for a lower prevalence of malar rash, photosensitivity and alopecia and a higher prevalence of mucosal ulcers in the late-onset group. A positive family history of SLE was obtained in 50 patients (7.2%). There were no statistical differences in clinical characteristics between familial SLE and sporadic SLE patients. The heritability of SLE was 43.6%, the genetic model of SLE could be polygenetic model and major gene mode is the best fitted one. SLE could be a multifactorial disease with polygenetic model.     

SLE患者外周血单一核细胞淋巴细胞功能相关抗原1表达的检测

目的 研究SLE患者外周血单一核细胞（PBMC）淋巴细胞功能相关抗原1（LFA-1）的表达,探讨LFA-1与SLE的发病及病情变化的关系及其临床意义。方法 提取30例SLE患者（SLE组）和24例正常人（对照组）的PBMC,用抗人CD3-FITC和抗人CD11a-PE对其进行标记后,采用流式细胞术检测其CD11a的表达率。结果 PBMC CD11a的表达率对照组为68.21% ± 4.58%,SLE组为73.74% ± 7.89%,活动期组为77.11% ± 7.46%,稳定期组为69.33% ± 6.27%,SLE组PBMC CD11a的表达率显著高于对照组（P ＜ 0.05）,且活动期组亦显著高于对照组（P ＜ 0.05）,而稳定期组与对照组比较,差异无统计学意义（P > 0.05）。活动期组与稳定期组比较,差异有统计学意义（P ＜ 0.05）。相关性分析显示,SLE患者CD11a的表达率与其采血时的SLEDAI呈正相关（r = 0.64,P ＜ 0.01）。结论 LFA-1的过表达参与SLE的发病,并与疾病活动相关。     

Frequency and severity of systemic disease in patients with subacute cutaneous lupus erythematosus

OBJECTIVE: To compare the frequency and severity of systemic disease in patients with subacute cutaneous lupus erythematosus (SCLE) followed up in a dermatology practice vs patients with systemic lupus erythematosus (SLE) followed up in a rheumatology practice. DESIGN: Case-control comparison of patients matched for age, sex, and ethnicity. SETTING: University-affiliated dermatology and rheumatology practices. PATIENTS: Seventy-six patients with SCLE were compared with 24 patients with SLE. INTERVENTION: All medical records were reviewed and the patients were interviewed. MAIN OUTCOME MEASURES: Systemic and serologic findings were compared between patients with SCLE and those with SLE. RESULTS: Hematologic disorders were present in 6 patients (8%) with SCLE and in 13 patients (54%) with SLE (P<.001). Serositis was present in 1 patient (1%) with SCLE and in 3 patients (12%) with SLE (P =.04). Renal involvement was present in 12 patients (16%) with SCLE and in 6 patients (25%) with SLE (P =.36). Antinuclear antibodies were found in 52 patients (68%) with SCLE compared with 23 patients (96%) with SLE (P =.006). Anti-Ro antibodies were found in 37 patients (49%) with SCLE compared with 10 patients (42%) with SLE (P =.64). Other serologic abnormalities (anti-native DNA, anti-Sm antibody, or anti-U(1)RNP) were present in 6 patients (8%) with SCLE compared with 15 patients (62%) with SLE (P<.001). Photosensitivity was present in 65 patients (86%) with SCLE, compared with 11 patients (46%) with SLE (P<.001). CONCLUSIONS: This analysis reveals a dissimilar frequency of internal organ involvement between patients with SCLE and SLE. Renal disease was similar in frequency and severity, and documented central nervous system involvement was rare in both groups.     

伴雷诺现象的系统性红斑狼疮42例分析

目的：了解伴雷诺现象（RP）的系统性红斑狼疮（SLE）患者的临床特征。方法：对近4年在我院住院的42例拌RP的SLE患者进行临床分析,并与116例无RP的SLE患者进行对照。结果：与无RP组相比,有RP组出现脱发、肌炎／肌病、心脏受累和肺动脉高压的几率明显增高（分别为56.90％－83.33％,9.48％－23.81％,29.31％－59.52％,1.72％－21.43％,P＜0.05或0.01）。γ－球蛋白升高,抗核抗体、抗RNP及抗Sm抗体的阳性率也明显增高（分别为50.52％－73.68％,68.47％－87.80％,24.04％－70.00％,7.69％－35.00％,P＜0.05或0.01）。而两组患者在肾炎、神经系统受累及血液系统受累的发生率差异无显著性（P均＞0.05）。对125例患者进行了平均2.15年的随访,其中包括全部的11例肺动脉高压患者,死亡3例,其中1例死于肺动脉高压并发右心衰竭（有RP组）。结论：SLE患者出现雷诺现象提示较易发生肺动脉高压、心脏受累和免疫学异常,对伴雷诺现象的SLE患者应注意其心肺状态,以便早期诊断和治疗。     

系统性红斑狼疮患者合并丙型肝炎病毒感染的临床分析

目的:确定系统性红斑狼疮(SLE)患者丙型肝炎病毒(HCV)感染的发病率及其临床意义。方法:用ELISA-3、RIBA-3及PCR检测134例SLE和200名正常献血者HCV感染情况。结果:15例SLE患者(11%)和2名对照组(1%)HCV抗体阳性(P<0.001),SLE患者合并HCV感染率明显高于对照组,合并HCV感染SLE患者的皮肤表现、ds-DNA抗体发生率低(P=0.01,P<0.001),肝脏损害、低补体血症、冷球蛋白血症发生率高(P<0.001,P=0.002,P=0.03,P=0.02)。结论:SLE患者的HCV感染率高于正常人群。     

芪加真武汤对系统性红斑狼疮患者外周血淋巴细胞凋亡及Fas和FasL表达的影响

目的探讨中药芪加真武汤对系统性红斑狼疮(SLE)患者外周血淋巴细胞(PBL)凋亡及Fas和FasL表达的影响。方法采用血清药理学的原理制取兔芪加真武汤含药血清。选取活动期SLE患者19例和正常人10名,分离PBL,将植物血凝素刺激后的PBL分别加入RPMI1640(含10%小牛血清)、含药血清(5%,10%,20%)培养72h,应用流式细胞仪检测其凋亡及Fas和FasL的表达。结果①SLE患者PBL凋亡率明显高于正常人(P<0.01),Fas表达明显升高(P<0.01)。②10%,20%含药血清组PBL的凋亡均较SLE显著减少(P<0.01),Fas表达显著降低(P<0.01),FasL的阳性表达率升高(P<0.05)。结论SLE患者PBL存在凋亡及Fas和FasL表达的紊乱。中药芪加真武汤可降低SLE患者外周血淋巴细胞Fas的表达和增加FasL的细胞阳性表达率,进而影响其凋亡。     

Mucosal involvement in systemic and chronic cutaneous lupus erythematosus

The prevalence and pattern of mucosal involvement in 121 patients with lupus erythematosus (LE) was investigated. Fifty-three patients had systemic LE (SLE) and 68 patients had chronic cutaneous LE (CCLE). Twenty-one per cent (11/53) of patients with SLE and 24% (16/68) of patients with CCLE had signs of mucosal involvement, but the pattern of involvement differed in the two groups. Nasal mucosal lesions were a feature in 2% (I/53) of patients with SLE and 9% (6/68) of patients with CCLE. Hyperkeratotic lichen planus-like plaques on buccal mucosa and the palate occurred in 9% (6/68) of patients with CCLE and 4% (2/53) of patients with SLE. Episcleritis occurred in 9% (5/53) of patients with SLE and not seen in CCLE. Erythematous plaques on the lower eyelids were present in 6% (4/68) of patients with CCLE and these were associated with conjunctival scarring in two patients. Vulval lesions were present in 5% (2/42) of female patients with CCLE. Oral plaques may occur when the disease is relatively quiescent elsewhere. The prevalence of mucosal involvement in lupus is underestimated as the lesions may be asymptomatic.     

羟氯喹逆转紫外线诱导的SLE患者CD4+T细胞DNA低甲基化的研究

目的 探讨羟氯喹对紫外线诱导的SLE患者CD4+ T细胞基因组DNA低甲基化的作用。方法 选择SLE患者组30例,正常人对照组10例。 磁珠分选SLE患者组和正常人对照组外周血CD4+ T细胞,311 nm窄谱UVB照射,加入羟氯喹共培养,检测各组间基因组DNA甲基化表达水平。结果 SLE患者组CD4+ T细胞DNA甲基化水平（3.922 ± 2.215）%低于正常人对照组［（10.210 ± 5.573）%,t = 3.450,P = 0.026］;SLE活动组患者CD4+ T细胞经45 mJ/cm2和100 mJ/cm2 UVB照射后DNA甲基化水平为（1.784 ± 1.033）%和（1.932 ± 1.844）%,均显著低于活动期患者未照射组［（3.922 ± 2.215）%,t = 3.000、4.118,P值均 < 0.05］。经100 mJ/cm2 UVB照射后,活动期患者DNA甲基化水平（1.932 ± 1.844）%显著低于稳定期患者照射组 ［（7.235 ± 3.846）%,t = 2.648,P < 0.05］和正常人对照组［（5.472 ± 5.573）%,t = 3.000,P < 0.05］。SLE活动组T细胞经45和100 mJ/cm2 UVB照射后,加用羟氯喹结果DNA甲基化水平为（4.698 ± 1.948）%和（8.698 ± 3.151）%,均比照射未加羟氯喹组显著升高（t = 4.827、3.184,P值均 < 0.05）;经45 mJ/cm2 UVB照射前后均加羟氯喹组DNA甲基化水平（5.404 ± 2.308）%比照射未加羟氯喹组（1.784 ± 1.033）%显著升高,t = 4.827,P < 0.01。结论 羟氯喹可以逆转紫外线诱导的SLE患者CD4+ T细胞DNA低甲基化,羟氯喹对活动期SLE患者更为明显。     

系统性红斑狼疮患者血浆DNA p16基因启动子的甲基化状态

目的 探讨系统性红斑狼疮(SLF)患者中p16基因的甲基化状态及其在发病机制中的作用。方法 检测45例SLE患者及20例健康对照者血浆DNA甲基化状态。应用甲基化特异PcR(MSP)方法检测p16基因启动子区甲基化状态,并分析与临床表现及常规实验室检查结果之间的关联。结果 在SLE患者血浆DNA中p16基因呈现高甲基化状态,占64.44%(29/45),而健康对照组中只有1例检测到p16基因高甲基化(1/20,5%),两组间差异有统计学意义(x²=19.69,P<0.01)。活动期SLE组p16基因呈高甲基化状态者所占比率83.33%(20/24),比非活动期SLE组42.85%,(9/21)高,差异也有统计学意义(x²=8.01;P<0.01)。但初发SLE组p16基因呈高甲基化状态者所占比例(71.43%,15/21)与复发SLE组(58.33%,14/24)相比差异无统计学意义(P=0.37)。具有下列临床表现的SLE患者其血浆p16基因高甲基化状态者所占比率相对较高:关节炎(57.5%,15/26),白细胞减少(42.3%,11/26),血沉增快(56%,14/25)。结论 活动期SLE患者血浆DNAp16基因启动子区呈现明显高甲基化状态,并与关节炎、白细胞减少及血沉增快等临床表现相关;提示p16基因启动子区高甲基化可能在SLE的发病机制中起作用。     

系统性红斑狼疮合并带状疱疹临床分析

目的：分析SLE患者的带状疱疹临床特点，以及探讨SLE患者的病情活动和治疗对发生带状疱疹的影响。方法：临床回顾1991－2000年住院合并有带状疱疹的SLE患者临床特点，对带状疱疹发生的一些可能的相关因素行分析比较和χ^2检验。结果：这一组患者中，带状疱疹的发生率为9．80％，高于同期全部住院患者带状疱疹的发生率，临床症状相对较重；带状疱疹的发生率在病情活动、应用糖皮质激素及环磷酰胺治疗时较高。结论：SLE容易合并带状疱疹；病情相对较重；病情活动、应用糖皮质激素及环磷酰胺治疗时带状疱疹的发生率较高。