抗核小体抗体测定在系统性红斑狼疮诊断中的意义及价值

目的探讨血清抗核小体抗体（AnuA）检测在系统性红斑狼疮（SLE）患者中的诊断价值,评价其在SLE疾病活动性方面的参考价值。方法采用酶联免疫吸附法检测67例SLE患者、53例其他风湿性疾病患者和27名健康对照者血清中AnuA水平,同时进行其他自身抗体的检测并与AnuA比较,根据系统性红斑狼疮活动指数（SLEDAI）进行评分。结果AnuA阳性率在SLE组明显高于疾病对照组和正常对照组（P〈0.01）。在SLE组AnuA的敏感性明显高于抗dsDNA抗体、抗DNP抗体、抗Sm抗体（P〈0.05）,而特异性无差异（P〉0.05）。AnuA在其他自身抗体阴性的SLE患者中仍有较高的检出率。AnuA分别与抗dsDNA抗体、抗DNP抗体和抗Sm抗体联合检测时的敏感性均高于自身抗体单个检测时的敏感性（P〈0.05）。AnuA水平与SLEDAI显著相关（r=0.484,P〈0.01）。结论AnuA的测定是诊断SLE敏感性和特异性都很高的实验室指标之一,与其他抗体联合检测可提高对SLE诊断的敏感性。AnuA与SLE病情活动密切相关。

The Diagnosis Significance of Serum Anti-Nucleosome Antibodies and its Value for Lupus Flare in Systemic Lupus Erythematosus

Objective To assess the utility of anti-nucleosome antibodies(AnuA) for the diagnosis of systemic lupus erythematosus(SLE) and as markers of disease activity.Methods AnuA were detected by enzyme-linked immunosorbent assays (ELISA) in the sera of 67 SLE patients,53 patients with other rheumatic diseasesand 27 healthy controls were also tested.Results The serum level of AnuA in SLE patients was significantly higher than that of the control groups(P<0.01).The incidence of AnuA was apparent higher than that of anti-dsDNA,anti-DNP and anti-Sm antibodies(P<0.01).The incidence of AnuA in SLE with negative anti-dsDNA,antiDNP and anti-Sm antibodies were 42.9%,52.6% and 62.0% respectively.The sensitivity of combination of AnuA and anti-dsDNA antibody or anti-DNP or anti-Sm antibodies were 70.1%,74.6% and 71.6% respectively.A significantly postive correlation was found between the levels of AnuA and SLEDAI scores(r=0.484,P<0.01).Conclusion Our data suggest that the AnuA may be a useful laboratory tests that can help in the diagnosis and assessment of disease activity in SLE.Combination of AnuA and other antibodies can significantly improve the sensitivity of these antibodies in the diagnosis of SLE.